Individual
CYNTHIA FULREADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1919 5TH ST, SANTA FE, NM 87505-5402
(505) 795-8831
Mailing address
2844 VEREDA DE PUEBLO, SANTA FE, NM 87507-5386
(505) 473-4420
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1808
NM
Other
Enumeration date
03/03/2012
Last updated
03/03/2012
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