| NPI | 1215453121 |
|---|---|
| Former Name | MICHELLE LEIGH FULLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 3757) |
| Additional Taxonomies | 1041S0200X Social Worker, School (Licence: LA AN550373) |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2020-07-27 |