Individual
JACQUELINE N FULCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LMSW
Contact information
Practice address
23327 N 44TH PL, PHOENIX, AZ 85050-8799
(520) 981-0618
Mailing address
23327 N 44TH PL, PHOENIX, AZ 85050-8799
(520) 981-0618
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
PSY-005312
AZ
103TC1900X
Counseling Psychologist
Primary
PSY-005312
AZ
Other
Enumeration date
10/22/2009
Last updated
01/05/2021
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