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General NPI Number Information
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NPI Number | 1538381439
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Entity Type | Individual
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Provider Name | PAULA DAVIS FULTZ P.C.C.-.S,R.D.,L.D.
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Gender | Female
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 303 E. BAGLEY ROAD
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City | BEREA
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State | OH
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Zip | 44017
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Country | US
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Telephone | 440-260-8375
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Fax | 440-260-8390
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Provider Business Mailing Address
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Address Line | 10509 KINGS WAY
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City | N. ROYALTON
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State | OH
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Zip | 44133-1970
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Country | US
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Telephone | 440-582-3744
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E0003210SUPV
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | LD861
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License Number State | OH
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