Individual
MRS. KAREN L FULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1217 STONE ST, JONESBORO, AR 72401-4520
(870) 972-1268
Mailing address
1217 STONE ST, JONESBORO, AR 72401-4520
(870) 972-1268
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1662-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5W981
BLUECROSS PROVIDER NUMBER
AR
Enumeration date
07/19/2006
Last updated
04/01/2024
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