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Individual

MS. JOAN N FULLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LPC

Contact information

Practice address
901 4TH ST, SUITE 160, HUDSON, WI 54016-1681
(763) 210-9966
(763) 210-6886
Mailing address
1497 MALLARD AVE, BALDWIN, WI 54002-5561
(651) 329-9112

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
08/08/2013
Last updated
10/12/2015
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