Individual
MARCIE SUSAN FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
6701 PARKWAY CIR STE 300, BROOKLYN CENTER, MN 55430-2849
(612) 767-7222
Mailing address
1161 BAY RD, MADISON, SD 57042-6763
(605) 777-4619
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
02340
MN
Other
Enumeration date
02/02/2021
Last updated
10/17/2025
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