Individual
MRS. JUDITH CUNNINGHAM FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W., L.C.S.W.
Contact information
Practice address
10845 OLIVE BLVD, SUITE 100, CREVE COEUR, MO 63141-7760
(314) 872-3132
(314) 872-3965
Mailing address
10845 OLIVE BLVD, SUITE 100, CREVE COEUR, MO 63141-7760
(314) 872-3132
(314) 872-3965
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
001679
MO
Other
Enumeration date
06/29/2007
Last updated
07/08/2007
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