Individual
JANA CLAIRE FULMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSC, CMHC
Contact information
Practice address
447 BEARCAT DR, SALT LAKE CITY, UT 84115-2519
(801) 355-2846
(801) 359-3244
Mailing address
200 PARKVIEW DR, PARK CITY, UT 84098-5144
(801) 355-2846
(801) 359-3244
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6053262-6004
UT
101YP2500X
Professional Counselor
6053262-6009
UT
Other
Enumeration date
11/29/2010
Last updated
11/07/2014
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