Individual
BRITTANY FULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
165 MAIN ST STE A, CORTLAND, NY 13045-3049
(607) 753-0234
Mailing address
165 MAIN ST STE A, CORTLAND, NY 13045-3049
(607) 753-0234
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
103611
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336163963
—
NY
Enumeration date
08/23/2018
Last updated
08/23/2018
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