Individual
TRACI L FULMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
11 OAKWOOD EST, DUNDEE, NY 14837-1154
(315) 640-1472
Mailing address
11 OAKWOOD EST, DUNDEE, NY 14837-1154
(315) 640-1472
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37331
NY
Other
Enumeration date
02/05/2024
Last updated
02/05/2024
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