Individual
VIVIAN EBI TANYI FULTANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6004 SPRINGHILL DR APT 204, GREENBELT, MD 20770-3159
(940) 230-9835
Mailing address
6004 SPRINGHILL DR APT 204, GREENBELT, MD 20770-3159
(940) 230-9835
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
MD
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/10/2026
Last updated
07/27/2026
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