Individual
SARAH FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
602 PETTIGRU ST, GREENVILLE, SC 29601
(864) 720-1616
Mailing address
128 MANCHESTER DR, MAULDIN, SC 29662-1867
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
6811
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821493826
—
SC
Enumeration date
11/03/2014
Last updated
07/02/2018
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