Individual
MRS. REBECCA MARIE-ROSE FULCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., BCBA
Contact information
Practice address
7230 ENGLE RD STE 102, FORT WAYNE, IN 46804-2234
(260) 373-1050
(260) 471-0285
Mailing address
670 CHADINGS DR, ROANOKE, IN 46783-8875
(423) 582-9494
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1107501
IL
Other
Enumeration date
11/20/2010
Last updated
12/31/2019
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