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ANGELA FULLERTON
Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1801568480
Individual Registrant: ANGELA FULLERTON
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
326 HIGHWAY 133 STE 270F CARBONDALE, CO 81623-2510 US
Tel: 970-710-9074 Fax: --
Tel: 970-710-9074 Fax: --
Contact information for business:
326 HIGHWAY 133 STE 270F CARBONDALE, CO 81623-2510 US
Tel: 970-710-9074 Fax: --
Tel: 970-710-9074 Fax: --
Registration Information:
NPI: 1801568480
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 101YA0400X | Behavioral Health & Social Service Providers Counselor Addiction (Substance Use Disorder) | ||
| Y | 101Y00000X | Behavioral Health & Social Service Providers Counselor |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
