Individual
GARRICK FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
607 DIVISION ST, NOME, AK 99762-0966
(907) 443-3344
Mailing address
PO BOX 262, NOME, AK 99762-0262
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
MO
Other
Enumeration date
01/13/2015
Last updated
01/13/2015
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