Individual
DR. HALEY FULFORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AU.D
Contact information
Practice address
1650 MARKET ST, PHILADELPHIA, PA 19103-7301
(215) 514-0760
Mailing address
20 ORTIZ DR, PENNSAUKEN, NJ 08110-1250
(215) 514-0760
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AT006575
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780016360
—
PA
Enumeration date
07/13/2018
Last updated
01/26/2024
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