Most Relevant Information
Provider Data
| NPI Number: | 1003582818 |
| Provider Name: | JANEESAH KELLY FULTON |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/20/2021 |
| Last Updated: | 08/20/2021 |
Provider Practice Location
260 PEACHTREE ST NW STE 2200
ATLANTA
GA
303031292
Practice Location Phone/Fax
| Phone: | 8774182978 |
| Fax: |
Provider Mailing Location
500 FAIRWAY DR STE 102
DEERFIELD BCH
FL
334411817
Provider Mailing Phone/Fax
| Phone: | 8774182978 |
| Fax: | 8665002186 |