Individual
LOUISE ELLA FULLERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
290 MOYER LN NW, EASTER SEAS CHILDREN'S GUILD, SALEM, OR 97304
(503) 370-8990
(503) 363-4214
Mailing address
710 STEWART ST NE, SALEM, OR 97301-2515
(503) 371-7496
(503) 363-4214
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C0696
OR
Other
Enumeration date
08/02/2006
Last updated
07/08/2007
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