Individual
YOLANDA MONIQUE FULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
711 PURDUVE AVE, WEST MEMPHIS, AR 72301
(901) 497-0513
Mailing address
P.O. BOX 1094, WEST MEMPHIS, AR 72303
(901) 497-0513
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
18752
AR
Other
Enumeration date
12/13/2019
Last updated
12/13/2019
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