Individual
EMERICK FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
719 W LAKE AVE, PEORIA, IL 61614-5941
(309) 408-1493
Mailing address
9821 ASHBURY CT, HANNA CITY, IL 61536-9690
(309) 253-9579
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/14/2024
Last updated
05/14/2024
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