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Individual

MARY FULTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
209 JEFFERSON ST, SUITE 1042, WINCHESTER, TN 37398
(931) 253-7075
(931) 208-3530
Mailing address
456 STILLWOOD DR, MANCHESTER, TN 37355-7343

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
TN

Other

Enumeration date
01/28/2026
Last updated
01/28/2026
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