Jared Austin Fulgham, CCC-SLP

NPI #1659932275 in Logan, Utah

Provider Information

NPI Number: 1659932275
Entity Type: Individual
Name: Jared Austin Fulgham, CCC-SLP
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Speech-Language Pathologist
Credential: CCC-SLP
Enumeration Date: Jun 25, 2019
Last Updated: Jun 25, 2019

Practice Location

Address: 6410 OLD MAIN HL
City: Logan
State: Utah
ZIP Code: 84322-6410
Phone: (435) 797-1375

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Speech-Language Pathologist	235Z00000X	Primary

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