Doctor Name: | MRS. FELICIA RAQUEL FULTON |
NPI Number: | 1093160020 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 741 Erika Ln Grovetown, GA - 308138305 |
Business Phone Number: | 9105519435 |
Business Fax Number: | |
Mailing Address: | 741 Erika Ln, GROVETOWN |
State: | GA |
Postal Code: | 308138305 |
Phone Number: | 9105519435 |
Fax Number: | |
NPI Enumeration Date: | 04/27/2016 |
NPI Last Update Date: | 04/27/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225800000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Recreation Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | A recreation therapist uses recreational activities for intervention in some physical, social or emotional behavior to bring about a desired change in that behavior and promote the growth and development of the patient. |