Organization
FULGRES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TONYA F. GREENE LPC (PRESIDENT)
(704) 449-8907
Entity
Organization
Contact information
Practice address
1945 J N PEASE PL, SUITE 204, CHARLOTTE, NC 28262-4511
(704) 449-8907
(704) 414-8461
Mailing address
PO BOX 32602, CHARLOTTE, NC 28232-2602
(704) 449-8907
(704) 414-8461
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6102488
—
NC
Enumeration date
04/12/2007
Last updated
07/26/2010
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