Individual
CALLIE BROOKE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, CSW
Contact information
Practice address
901 LEHMAN AVE STE 7, BOWLING GREEN, KY 42101-4903
(270) 904-6307
(270) 904-6314
Mailing address
10100 ELIDA RD, DELPHOS, OH 45833-9058
(419) 695-8010
(419) 695-0004
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
255683
KY
1041C0700X
Clinical Social Worker
Primary
255987
KY
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
01/15/2021
Last updated
08/31/2021
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