Provider Demographics
NPI:1114693561
Name:FLETCHER, URSULA G
Entity Type:Individual
Prefix:
First Name:URSULA
Middle Name:G
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:677 S SMITH ST
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34453-0874
Mailing Address - Country:US
Mailing Address - Phone:352-726-2143
Mailing Address - Fax:
Practice Address - Street 1:1554 N MEADOWCREST BLVD
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429-5756
Practice Address - Country:US
Practice Address - Phone:352-228-4470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor