Individual
MRS. JOAN T. FULBRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
685 HOLLYWOOD HWY, CLARKESVILLE, GA 30523-4732
(706) 754-3961
Mailing address
685 HOLLYWOOD HWY, CLARKESVILLE, GA 30523-4732
(706) 754-3961
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW002853
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CSW002853
STATE LICENSE
GA
Enumeration date
04/18/2007
Last updated
07/09/2007
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