Fuller, Larry Dewitt

Fuller, Larry Dewitt is an individual health care provider with primary practice located at 307 Old Stone Rd , Villa Rica GA 30180-1214. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Fuller, Larry Dewitt can be contacted via phone (770) 459-8799.

Contact Information

Primary practice address
307 Old Stone Rd Villa Rica GA 30180-1214
Phone: (770) 459-8799
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC007525 Georgia

Profile Details

NPI number 1700209327
LBN Legal business name Fuller, Larry Dewitt
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 3rd, 2014
Last updated Feb 3rd, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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