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Individual
MISS SHELLEY S FULLENKAMP
Active
Individual
MISS SHELLEY S FULLENKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C. 0027325
OH
104100000X
Social Worker
S. 0027325
OH
Other
Enumeration date
09/30/2008
Last updated
09/21/2012
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