Fullmer, Anna R

Fullmer, Anna R is an individual health care provider with primary practice located at 400 S Townline Rd , Wautoma WI 54982-6922. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Fullmer, Anna R can be contacted via phone (920) 787-5514.

Contact Information

Primary practice address
400 S Townline Rd Wautoma WI 54982-6922
Phone: (920) 787-5514
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 6573-123 Wisconsin

Profile Details

NPI number 1306897467
LBN Legal business name Fullmer, Anna R
Credentials MSSW, LCSW
Entity Individual
Sole proprietor 1 No
Enumeration date May 13th, 2006
Last updated Jun 13th, 2024 - about last year

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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Identifiers

StateTypeNumberIssuer
All States NPI 1306897467 NPPES
Wisconsin MEDICAID 39797500

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