Individual
ASHANTA FULMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6600 W CHARLESTON BLVD, STE. 140, LAS VEGAS, NV 89146
(702) 440-8440
Mailing address
6600 W CHARLESTON BLVD, STE. 140, LAS VEGAS, NV 89146
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
06/26/2019
Last updated
12/02/2025
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