Individual
MS. JENNIFER D FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.C., C.A.C. II
Contact information
Practice address
304 W BASELINE RD, LAFAYETTE, CO 80026-1719
(303) 827-4973
Mailing address
1109 STEIN ST, LAFAYETTE, CO 80026-1850
(303) 827-4973
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
7203
CO
101YM0800X
Mental Health Counselor
Primary
5780
CO
Other
Enumeration date
05/12/2011
Last updated
09/15/2016
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