Latisha Fuller

NPI #1003158320 in Tulsa, Oklahoma

Provider Information

NPI Number: 1003158320
Entity Type: Individual
Name: Latisha Fuller
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Mental Health
Enumeration Date: Mar 25, 2013
Last Updated: Mar 25, 2013

Practice Location

Address: 5125 S UTICA AVE APT 4
City: Tulsa
State: Oklahoma
ZIP Code: 74105-5727
Phone: (918) 734-5259

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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