Individual
MR. STEVEN MICHAEL FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, LMFT
Contact information
Practice address
4202 SW LEE BLVD., PARK RIDGE PROFESSIONAL CENTER, LAWTON, OK 73505
(580) 585-3346
Mailing address
PO BOX 655, ANADARKO, OK 73005-0655
(580) 585-3346
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
200
OK
106H00000X
Marriage & Family Therapist
88
OK
Other
Enumeration date
06/28/2013
Last updated
06/28/2013
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