Individual
REID FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
285 TALLYHO DR, AUBURN, AL 36832-8646
(334) 275-5091
Mailing address
285 TALLYHO DR, AUBURN, AL 36832-8646
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
9921257
CO
1041C0700X
Clinical Social Worker
Primary
9926168
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9921257
LCSW COLORADO
CO
Enumeration date
11/17/2021
Last updated
11/17/2021
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