Individual
TERAN RENEE FULFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SPEECH THERAPIST
Contact information
Practice address
298 JAY ST, PRATTVILLE, AL 36066-6062
(334) 361-6008
(334) 491-0500
Mailing address
1937 TARA DR, PRATTVILLE, AL 36066-7526
(334) 491-0148
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1546
AL
Other
Enumeration date
04/10/2008
Last updated
04/10/2008
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