Organization
FULLER COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANEKA FULLER LPC (OWNER)
(318) 458-7255
Entity
Organization
Contact information
Practice address
2285 BENTON RD STE 107GOP, BOSSIER CITY, LA 71111-7933
(318) 458-7255
Mailing address
2113 SWEET BAY CIR, BOSSIER CITY, LA 71111-6727
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4867
LA
Other
Enumeration date
03/05/2014
Last updated
03/05/2014
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