Individual
JORDYN FULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
738 W ARMY TRAIL RD, CAROL STREAM, IL 60188
(815) 469-1500
Mailing address
5 REVERE DR STE 120, NORTHBROOK, IL 60062-8005
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225X00000X
Occupational Therapist
Primary
056.015144
IL
Other
Enumeration date
06/12/2019
Last updated
11/09/2022
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