Individual
JESSICA TIARA FULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 CHERRY ST UNIT A, ANCHORAGE, AK 99504-2230
(907) 306-4173
Mailing address
400 W 76TH AVE APT 105, ANCHORAGE, AK 99518-2551
(907) 306-4173
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
101114
AK
Other
Enumeration date
01/04/2018
Last updated
01/04/2018
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