Organization
FULP THERAPY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIM FULP M.A., CCC-SLP (PRESIDENT/SPEECH PATHOLOGIST)
(336) 725-3911
Entity
Organization
Contact information
Practice address
2430 REYNOLDA RD, WINSTON SALEM, NC 27106-4606
(336) 725-3911
(336) 725-3995
Mailing address
2430 REYNOLDA RD, WINSTON SALEM, NC 27106-4606
(336) 725-3911
(336) 725-3995
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2306
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013T5
BCBS
NC
05
—
7210759
—
NC
05
—
7411912
—
NC
05
—
7434118
—
NC
01
—
C1898
MEDCOST
NC
01
—
C1899
MEDCOST
NC
Enumeration date
12/21/2005
Last updated
08/22/2020
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