Individual
JEFFERY FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYCHOLOGIST
Contact information
Practice address
8270 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031-4511
(301) 399-1916
Mailing address
8270 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031-4511
(301) 399-1916
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
PPS0601172
VA
Other
Enumeration date
03/12/2018
Last updated
03/17/2018
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