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1336519677
EBONY FULLER
BOSSIER CITY, LA
NPI
1336519677
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2015-09-29
Last Update Date
2019-07-29
Business Address
EBONY FULLER
52 TURNBURY DR
BOSSIER CITY, LA 71111-8203
Phone number: 318-655-5720
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Mailing Address
EBONY FULLER
52 TURNBURY DR
BOSSIER CITY, LA 71111-8203
Phone number:
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