Provider Demographics
NPI:1477384543
Name:FULTON, DEBRA L (LPC)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:L
Last Name:FULTON
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 1:1309 DUNBARTON DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-5916
Mailing Address - Country:US
Mailing Address - Phone:817-528-3580
Mailing Address - Fax:
Practice Address - Street 1:12801 N CENTRAL EXPY STE 510
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-1842
Practice Address - Country:US
Practice Address - Phone:469-987-8522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77918101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional