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Individual

JONAI ALISIA FULLARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
411 BUCKINGHAM RD APT 1331, RICHARDSON, TX 75081-5790
(972) 454-0414
Mailing address
411 BUCKINGHAM RD APT 1331, RICHARDSON, TX 75081-5790

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
112176
TX

Other

Enumeration date
01/25/2024
Last updated
01/28/2024
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