Individual
ANITA LYNNE FULMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
6270 SALEM CIR APT 120, FORT WORTH, TX 76132-3003
(936) 615-8595
Mailing address
6270 SALEM CIR APT 120, FORT WORTH, TX 76132-3003
(936) 615-8595
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12505
TX
Other
Enumeration date
08/12/2020
Last updated
08/12/2020
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