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1518294693
TINA JEAN FULLER
MCALESTER, OK
NPI
1518294693
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OK under supervison)
Enumeration Date
2009-11-10
Last Update Date
2010-10-18
Business Address
Mrs. TINA JEAN FULLER MS LADC/US
1101 E MONROE AVE
MCALESTER, OK 74501-4815
Phone number: 918-426-7800
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Mailing Address
Mrs. TINA JEAN FULLER MS LADC/US
3751 WAYSIDE LN
MCALESTER, OK 74501-7643
Phone number: 918-329-1476
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