Provider Demographics
NPI:1104850395
Name:FULMER, MARGARET LOUISE (MS ED)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:LOUISE
Last Name:FULMER
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 CARPENTERS LN
Mailing Address - Street 2:
Mailing Address - City:PENNSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:17756-7123
Mailing Address - Country:US
Mailing Address - Phone:570-546-8766
Mailing Address - Fax:570-322-8026
Practice Address - Street 1:435 W 4TH ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-6001
Practice Address - Country:US
Practice Address - Phone:570-322-7873
Practice Address - Fax:570-322-8026
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist