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General NPI Number Information
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NPI Number | 1417414525
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Entity Type | Organization
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Legal Business Name | FOREST PATH COUNSELING & WELLNESS LISA FULFOR PLLC
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Dates
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Enumeration Date | 02/25/2019
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Last Update Date | 04/24/2019
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Provider Practice Location Address
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Address Line | 8105 RASOR BLVD STE 225
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City | PLANO
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State | TX
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Zip | 75024-0265
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Country | US
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Telephone | 214-316-0924
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Fax |
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Provider Business Mailing Address
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Address Line | 13254 LIME RIDGE DR
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City | FRISCO
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State | TX
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Zip | 75033-0938
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Country | US
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Telephone | 214-316-0924
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LISA FULFOR
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Credential | LCSW
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Telephone | 214-316-0924
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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