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Individual

MS. AMEE DAN FULFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BS, MHR, LPC

Contact information

Practice address
4200 E STATE HIGHWAY 52, HARTFORD, AL 36344-5122
(345) 890-8743
Mailing address
491 LEWIS RD, SLOCOMB, AL 36375-5325
(345) 890-8743

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
101YP2500X
Professional Counselor
LPC05388
AL
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
12/02/2014
Last updated
10/22/2024
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