Provider Demographics
NPI:1184362113
Name:FULMER, BARBARA MICHELLE (LICSWPIP,)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:MICHELLE
Last Name:FULMER
Suffix:
Gender:F
Credentials:LICSWPIP,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 WOODVALE AVE
Mailing Address - Street 2:
Mailing Address - City:WEAVER
Mailing Address - State:AL
Mailing Address - Zip Code:36277-4866
Mailing Address - Country:US
Mailing Address - Phone:256-453-5476
Mailing Address - Fax:
Practice Address - Street 1:301 WOODVALE AVE
Practice Address - Street 2:
Practice Address - City:WEAVER
Practice Address - State:AL
Practice Address - Zip Code:36277-4866
Practice Address - Country:US
Practice Address - Phone:256-453-5476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4006C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical