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General NPI Number Information
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NPI Number | 1265203111
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Entity Type | Individual
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Provider Name | TROY FULFORD MDIV, MA, MFT
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Gender | Male
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Dates
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Enumeration Date | 01/10/2024
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 2106 BRAEWICK CIR STE 201&202
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City | AKRON
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State | OH
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Zip | 44313-6262
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Country | US
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Telephone | 234-303-2325
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Fax |
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Provider Business Mailing Address
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Address Line | 2106 BRAEWICK CIR STE 201&202
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City | AKRON
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State | OH
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Zip | 44313-6262
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Country | US
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Telephone | 234-303-2325
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | M.2400324
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License Number State | OH
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