Individual
ALYSSA FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5465 GRAND AVE STE 101, GURNEE, IL 60031-4913
(224) 303-4395
Mailing address
100 MALTON RD, NEGAUNEE, MI 49866-2001
(906) 228-9699
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150118870
IL
Other
Enumeration date
10/07/2024
Last updated
01/05/2026
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