Individual
KRISTIN SWAFFER FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4482 COMMERCE DR, SUITE 101, BUFORD, GA 30518-7512
(678) 463-3905
Mailing address
1344 MAPLE BEND TRL, LAWRENCEVILLE, GA 30043-5270
(678) 463-3905
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW003674
GA
Other
Enumeration date
09/27/2006
Last updated
07/08/2007
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