Individual
LISA BARRY FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1672 COLUMBIA HWY, DOTHAN, AL 36303-5434
(334) 712-6400
(334) 712-2676
Mailing address
1672 COLUMBIA HWY, DOTHAN, AL 36303-5434
(334) 712-6400
(334) 712-2676
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3364
AL
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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