Individual
BROOK ALEXIS FULTON-DELONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC, NCC
Contact information
Practice address
8181 MAIN ST APT 2, ELLICOTT CITY, MD 21043-4929
(757) 651-3001
(757) 222-3833
Mailing address
8181 MAIN ST APT 2, ELLICOTT CITY, MD 21043-4929
(410) 505-0062
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC12594
MD
101YM0800X
Mental Health Counselor
LGP10581
MD
Other
Enumeration date
07/14/2020
Last updated
11/16/2022
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