Most Relevant Information
Provider Data
| NPI Number: | 1003209289 |
| Provider Name: | JESSICA FULLER LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 61773 |
Most Important Dates
| Enumeration Date: | 03/11/2015 |
| Last Updated: | 09/20/2024 |
Provider Practice Location
3551 ROGER BROOKE DR
FORT SAM HOUSTON
TX
782344504
Practice Location Phone/Fax
| Phone: | 2108081859 |
| Fax: |
Provider Mailing Location
3551 ROGER BROOKE DR
FORT SAM HOUSTON
TX
782344504
Provider Mailing Phone/Fax
| Phone: | 2108081859 |
| Fax: |