Individual
ANNE-LISE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
603 MUIRFIELD CT, MARTINEZ, GA 30907-9575
(404) 693-0718
Mailing address
603 MUIRFIELD CT, MARTINEZ, GA 30907-9575
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC005756
GA
Other
Enumeration date
02/06/2015
Last updated
02/06/2015
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