Individual
STEPHANIE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
600 42ND ST, DES MOINES, IA 50312-2701
(515) 255-8399
Mailing address
600 42ND ST, DES MOINES, IA 50312-2701
(515) 255-8399
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
077140
IA
Other
Enumeration date
03/22/2016
Last updated
03/22/2016
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