Individual
MRS. SUSAN PATRICIA FULLERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
2060 CENTRE POINTE BLVD, SAINT PAUL, MN 55120-1269
(651) 774-0011
(651) 774-0606
Mailing address
830 BOONE AVE N, GOLDEN VALLEY, MN 55427-4568
(763) 331-3033
(763) 331-3039
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC00976
MN
Other
Enumeration date
05/12/2015
Last updated
05/12/2015
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