Individual
JESSICA LANDRY FULTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
221 N MONROE ST, SUITE B, MARKSVILLE, LA 71351-2311
(318) 305-9210
Mailing address
PO BOX 65, HESSMER, LA 71341-0065
(318) 305-9210
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11307
LA
Other
Enumeration date
09/01/2010
Last updated
10/02/2014
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