Individual
MS. DANA MARIE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
691 ORCHARD LAKE RD, PONTIAC, MI 48341-2039
(248) 874-1282
Mailing address
691 ORCHARD LAKE RD, PONTIAC, MI 48341
(248) 874-1282
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401008611
MI
Other
Enumeration date
10/14/2013
Last updated
10/14/2013
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