Most Relevant Information
Provider Data
| NPI Number: | 1003329228 |
| Provider Name: | FATIMAAH D FULLILOVE LSW, LICDC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 162016 |
Most Important Dates
| Enumeration Date: | 11/09/2017 |
| Last Updated: | 05/28/2024 |
Provider Practice Location
7232 JUSTIN WAY
MENTOR
OH
440604881
Practice Location Phone/Fax
| Phone: | 4405788200 |
| Fax: |
Provider Mailing Location
7232 JUSTIN WAY
MENTOR
OH
440604881
Provider Mailing Phone/Fax
| Phone: | 4405788200 |
| Fax: |