| NPI | 1982838009 |
|---|---|
| Former Name | JEAN ANNETTE FULLERTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2009-05-04 |