Individual
REBECCA L FULKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
RR 5 BOX 800, SANDY HOOK, KY 41171-9200
(606) 738-6163
(606) 738-5030
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
(606) 329-8588
(606) 329-8195
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1934
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11658501
CAQH
—
05
—
30610026
—
KY
Enumeration date
08/30/2006
Last updated
07/08/2007
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