Provider Demographics
NPI:1477950715
Name:FULFORD, AMEE DAN (BS, MHR, ALC)
Entity Type:Individual
Prefix:MS
First Name:AMEE
Middle Name:DAN
Last Name:FULFORD
Suffix:
Gender:F
Credentials:BS, MHR, ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 LEWIS RD
Mailing Address - Street 2:
Mailing Address - City:SLOCOMB
Mailing Address - State:AL
Mailing Address - Zip Code:36375-5325
Mailing Address - Country:US
Mailing Address - Phone:345-890-8743
Mailing Address - Fax:
Practice Address - Street 1:491 LEWIS RD
Practice Address - Street 2:
Practice Address - City:SLOCOMB
Practice Address - State:AL
Practice Address - Zip Code:36375-5325
Practice Address - Country:US
Practice Address - Phone:345-890-8743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-02
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator