Individual
LISA FULLERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APSW
Contact information
Practice address
210 E OLIN AVE, MADISON, WI 53713-1434
(608) 280-2700
Mailing address
25 KESSEL CT STE 105, MADISON, WI 53711-6227
(608) 280-2602
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
134802-121
WI
Other
Enumeration date
05/31/2024
Last updated
05/31/2024
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