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1750996104
SARA FULLER
PORTLAND, OR
NPI
1750996104
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: OR R5544)
Enumeration Date
2020-09-12
Last Update Date
2021-08-17
Business Address
SARA FULLER LMHCA, LPC Intern
3583 NE BROADWAY ST
PORTLAND, OR 97232-1820
Phone number: 503-912-8939
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Mailing Address
SARA FULLER LMHCA, LPC Intern
2425 NE 50TH AVE # 13656
PORTLAND, OR 97213-0030
Phone number: 503-912-8939
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