Individual
COURTNEY FULMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8296 OLD COURTHOUSE RD, VIENNA, VA 22182-3852
(703) 830-1136
Mailing address
8296 OLD COURTHOUSE RD, VIENNA, VA 22182-3852
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
235Z00000X
—
DC
Enumeration date
10/02/2014
Last updated
10/02/2014
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