Fultz, Dwight E

Fultz, Dwight E is an sole proprietor health care provider with primary practice located at 1003 Hollinger St , Park Rapids MN 56470-1300. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Fultz, Dwight E can be contacted via phone (218) 366-2636.

Contact Information

Primary practice address
1003 Hollinger St Park Rapids MN 56470-1300
Phone: (218) 366-2636
Fax: (218) 366-2087
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP4277 Minnesota

Profile Details

NPI number 1033628805
LBN Legal business name Fultz, Dwight E
Credentials PHD, LP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 25th, 2017
Last updated Sep 25th, 2017 - about 8 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 1033628805 NPPES
Minnesota Other LP4277 STATE OF MINNESOTA - MINNESOTA BOARD OF PSYCHOLOGY

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