Individual
LINDA LEE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
2334 BENJAMIN BLVD., LA POINTE, WI 54850-0481
(715) 747-2233
Mailing address
PO BOX 481, LA POINTE, WI 54850-0481
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2783123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39239700
—
WI
Enumeration date
10/01/2007
Last updated
12/12/2008
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