Individual
DR. JAMES O. FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH. D., LMHC
Contact information
Practice address
718 W SPENCER AVE, MARION, IN 46952-3424
(765) 677-2570
(765) 677-1456
Mailing address
718 W SPENCER AVE, MARION, IN 46952-3424
(765) 677-2570
(765) 677-1456
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39000402A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39000402A
LMHC NUMBER
IN
Enumeration date
05/16/2007
Last updated
07/08/2007
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