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1306289970
TANEKA M FULLER
SHREVEPORT, LA
NPI
1306289970
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: LA 4867)
Enumeration Date
2013-04-12
Last Update Date
2013-04-12
Business Address
-- TANEKA M FULLER LPC
1406 HAWN AVE
SHREVEPORT, LA 71107-6532
Phone number: 318-675-0224
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Mailing Address
-- TANEKA M FULLER LPC
PO BOX 78776
SHREVEPORT, LA 71137-8776
Phone number: 318-675-0224
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