Fulghum, Mary Alice

Fulghum, Mary Alice is an sole proprietor health care provider with primary practice located at 9791 Old Saint Augustine Rd , Jacksonville FL 32257-6035. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Marriage & Family Therapist is her primary health care specialty. Fulghum, Mary Alice can be contacted via phone (904) 762-4040.

Contact Information

Primary practice address
9791 Old Saint Augustine Rd Jacksonville FL 32257-6035
Phone: (904) 762-4040
Fax: (904) 238-5078
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X MT 2553 Florida
Behavioral Health & Social Service Providers / Professional 101YP2500X 929 Mississippi

Profile Details

NPI number 1831273275
LBN Legal business name Fulghum, Mary Alice
Credentials LMFT, L.P.C.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 24th, 2006
Last updated May 21st, 2012 - about 13 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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