Individual
JANEE' LENESE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
4795 BROADWAY, GARY, IN 46409-2403
(219) 887-3688
(219) 882-2666
Mailing address
4795 BROADWAY, GARY, IN 46409-2403
(219) 887-3688
(219) 887-2666
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/28/2014
Last updated
09/30/2015
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