Individual
MRS. AMY ELLEN FULLERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA. LLPC
Contact information
Practice address
738 S MAIN ST, STE 202, ADRIAN, MI 49221-3787
(517) 266-8880
Mailing address
10678 LAWRENCE RD, BROOKLYN, MI 49230-9546
(517) 673-5382
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
L2237191
MI
Other
Enumeration date
05/17/2012
Last updated
05/17/2012
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