Individual
MS. GERRY L. FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7272 WURZBACH RD, SUITE 601, SAN ANTONIO, TX 78240-4801
(210) 615-8880
(210) 593-9863
Mailing address
7272 WURZBACH RD, SUITE 601, SAN ANTONIO, TX 78240-4801
(210) 615-8880
(210) 593-9863
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1402-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1402-C
LICENSE
AR
Enumeration date
04/09/2012
Last updated
04/09/2012
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