Organization
FULLMER COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NATHAN FULLMER LCPC (OWNER)
(208) 521-4332
Entity
Organization
Contact information
Practice address
545 SHOUP AVE, SUITE 334, IDAHO FALLS, ID 83402-3575
(208) 521-4332
Mailing address
545 SHOUP AVE, SUITE 334, IDAHO FALLS, ID 83402-3575
(208) 521-4332
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/27/2014
Last updated
09/27/2014
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