Individual
MRS. JOSEPHINE ANN FULTZ
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
L.P.
Contact information
Practice address
403 4TH ST NW, SUITE 110, BEMIDJI, MN 56601-3142
(218) 751-1987
Mailing address
403 4TH ST NW, P.O. BOX 741, BEMIDJI, MN 56601-3155
(218) 751-1987
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
LP2849
MN
Other
Enumeration date
07/28/2005
Last updated
07/08/2007
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