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Search › Wisconsin › 1041C0700X

Mark Fuller, LCSW, SAC, ICS,

NPI 1780859744 · on the registry since 2008

Practice

Address
W3275 Wolf River Road
Keshena, WI 54135
Phone
(715) 799-5451
Organisation at this address
Menominee Indian Tribe Of Wisconsin
Menominee Indian Tribe Of Wisconsin
Menominee Indian Tribe Of Wisconsin
Menominee Indian Tribe Of Wisconsin
Menominee Indian Tribe Of Wisconsin
Inferred from a shared address, not stated in the registry.
Clinicians at this address
29

Registry record

Primary taxonomy
1041C0700X
1041C0700X
Licence states on file
WI
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2016-03-18

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin