| Doctor Name: | DR. REGINA SHARNEE FULTS-MCMURTERY |
| NPI Number: | 1023441870 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 0938 |
| Business Practice Address: | 661 Highway 51 Suite 1d Ridgeland, MS - 391572130 |
| Business Phone Number: | 6015629763 |
| Business Fax Number: | |
| Mailing Address: | 230 Pearlie Owens Dr, JACKSON |
| State: | MS |
| Postal Code: | 392123276 |
| Phone Number: | 6015629763 |
| Fax Number: | |
| NPI Enumeration Date: | 08/15/2013 |
| NPI Last Update Date: | 08/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 0938 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |