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1003158320
LATISHA FULLER
TULSA, OK
NPI
1003158320
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2013-03-25
Last Update Date
2013-03-25
Business Address
-- LATISHA FULLER
5125 S UTICA AVE APT 4
TULSA, OK 74105-5727
Phone number: 918-734-5259
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Mailing Address
-- LATISHA FULLER
5125 S UTICA AVE APT 4
TULSA, OK 74105-5727
Phone number: 918-734-5259
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