Individual
MRS. KELLY SUE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
1545 CROSSWAYS BLVD STE 250, CHESAPEAKE, VA 23320-0218
(757) 419-1726
Mailing address
310 FLAX MILL WAY, CHESAPEAKE, VA 23322-5893
(757) 419-1726
(757) 419-1726
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701003292
VA
101YP2500X
Professional Counselor
4184
NC
Other
Enumeration date
04/03/2007
Last updated
04/22/2024
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