Provider Demographics
NPI:1699592501
Name:FULTON, DAWNA (LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:DAWNA
Middle Name:
Last Name:FULTON
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 MCDONALD DR
Mailing Address - Street 2:
Mailing Address - City:EARLY
Mailing Address - State:TX
Mailing Address - Zip Code:76802-2329
Mailing Address - Country:US
Mailing Address - Phone:325-203-1256
Mailing Address - Fax:
Practice Address - Street 1:110 MCDONALD DR
Practice Address - Street 2:
Practice Address - City:EARLY
Practice Address - State:TX
Practice Address - Zip Code:76802-2329
Practice Address - Country:US
Practice Address - Phone:325-203-1256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96453101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor