Individual
KOREY FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
52 TURNBURY DR, BOSSIER CITY, LA 71111-8203
(318) 834-6048
Mailing address
52 TURNBURY DR, BOSSIER CITY, LA 71111-8203
(318) 834-6048
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/28/2015
Last updated
10/28/2015
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