Provider Demographics
NPI:1083359210
Name:FULTINEER, JULIANNA ASELLE (LPC)
Entity Type:Individual
Prefix:
First Name:JULIANNA
Middle Name:ASELLE
Last Name:FULTINEER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 SPRING CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1455
Mailing Address - Country:US
Mailing Address - Phone:541-601-2207
Mailing Address - Fax:
Practice Address - Street 1:300 E HERSEY ST STE 14
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-6200
Practice Address - Country:US
Practice Address - Phone:541-708-1510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-02
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR6654101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health