Jacqueline Nicole Fullerton

NPI #1083144828 in Tuba City, Arizona

Provider Information

NPI Number
1083144828
Entity Type
Individual
Name
Jacqueline Nicole Fullerton
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Occupational Therapist
Enumeration Date
Jun 14, 2017
Last Updated
Jun 14, 2017

Practice Location

Address
167 NORTH MAIN STREET
State
Arizona
ZIP Code
86045
Phone
(928) 283-2590

Specialties & Taxonomy Codes

Specialty
Occupational Therapist

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