Individual
MR. PAUL FULLERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, MSW
Contact information
Practice address
2800 ELM ST, SAINT CHARLES, MO 63301-4618
(314) 787-5100
(314) 754-2800
Mailing address
8631 DELMAR BLVD, SAINT LOUIS, MO 63124-1990
(314) 787-5100
(314) 754-2800
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
000484
MO
Other
Enumeration date
07/08/2006
Last updated
07/08/2007
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