Individual
NATHAN FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC014076
Contact information
Practice address
224 HERSHELS WAY, CLARKESVILLE, GA 30523-4169
(912) 695-5020
Mailing address
224 HERSHELS WAY, CLARKESVILLE, GA 30523-4169
(912) 695-5020
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/09/2021
Last updated
04/02/2024
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