Individual
BRENDA FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
233 FULLER LN, FRIERSON, LA 71027-2074
(318) 560-5390
Mailing address
233 FULLER LN, FRIERSON, LA 71027-2074
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/16/2016
Last updated
01/14/2019
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