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Individual
MR. DAVID DANIEL FULLER
Active
Individual
MR. DAVID DANIEL FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW79530
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
CA
1041C0700X
Clinical Social Worker
Primary
LCSW79530
CA
Other
Enumeration date
07/16/2014
Last updated
05/20/2019
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