| NPI | 1699115139 |
|---|---|
| Other Name | S. MICHAEL FULLER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 200) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OK 88) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2013-06-28 |