Individual
MRS. FATIMAAH D FULLILOVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW, LICDC
Contact information
Practice address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 578-8200
Mailing address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 578-8200
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
162016
OH
104100000X
Social Worker
2106096
OH
1041C0700X
Clinical Social Worker
Primary
S.2106096
OH
Other
Enumeration date
11/09/2017
Last updated
02/25/2025
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