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Individual

MS. JANE CATHERINE FULLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
8585 BROADWAY, SUITE 520, MERRILLVILLE, IN 46410-7064
(219) 942-0076
Mailing address
1040 GARFIELD ST, HOBART, IN 46342-6030
(219) 942-0076

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
IN

Other

Enumeration date
11/27/2007
Last updated
11/27/2007
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