Individual
LAUREN FULLERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., LADC
Contact information
Practice address
1821 UNIVERSITY AVE W., SUITE N385, ST. PAUL, MN 55104
(612) 454-2478
Mailing address
1821 UNIVERSITY AVE W., SUITE N385, ST. PAUL, MN 55104
(612) 454-2478
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
304871
MN
101YP2500X
Professional Counselor
Primary
3696
MN
Other
Enumeration date
03/01/2018
Last updated
05/05/2023
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