Individual
BERNITA WYNN FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLPC
Contact information
Practice address
806 TUURI PL, FLINT, MI 48503-2465
(810) 767-5750
Mailing address
1303 HORIZON DR, LAPEER, MI 48446-8663
(810) 767-5750
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
L928846
MI
Other
Enumeration date
01/10/2007
Last updated
07/08/2007
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