Individual
MS. SALOME FULKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1476 HWY 85 WEST, SACRAMENTO, KY 42372
(270) 499-2915
Mailing address
1476 HIGHWAY 85 W, SACRAMENTO, KY 42372-9534
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
8123
KY
Other
Enumeration date
08/22/2014
Last updated
08/22/2014
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