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:
Health care specialties
| Specialty | Code | License # | 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 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033628805 | NPPES |
| Minnesota | Other | LP4277 | STATE OF MINNESOTA - MINNESOTA BOARD OF PSYCHOLOGY |
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