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Individual

LISA FULTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW, LMSW

Contact information

Practice address
8000 W 127TH ST, OVERLAND PARK, KS 66213-2714
(816) 508-3313
(816) 508-3321
Mailing address
8000 W 127TH ST, OVERLAND PARK, KS 66213-2714
(816) 508-3313
(816) 508-3321

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
7280
KS
1041C0700X
Clinical Social Worker
Primary
2009001735
MO

Other

Enumeration date
12/04/2009
Last updated
08/11/2011
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