Broman-Fulks, Joshua Jefferson

Broman-Fulks, Joshua Jefferson is an sole proprietor health care provider with primary practice located at 222 Birch St , Boone NC 28607-5067. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Exercise & Sports. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Broman-Fulks, Joshua Jefferson can be contacted via phone (828) 406-1760.

Contact Information

Primary practice address
222 Birch St Boone NC 28607-5067
Phone: (828) 406-1760
Fax: (828) 264-6512
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 3587 North Carolina
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X 3587 North Carolina
Behavioral Health & Social Service Providers / Exercise & Sports 103TE1100X 3587 North Carolina

Profile Details

NPI number 1184702151
LBN Legal business name Broman-Fulks, Joshua Jefferson
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 1st, 2006
Last updated Sep 14th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184702151 NPPES
North Carolina MEDICAID 6001066
North Carolina Other 069UW

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