Basic Information
| Provider Information | |||||||||
| NPI: | 1811323280 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FULLER | ||||||||
| FirstName: | APRIL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | L.S.W. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 610 CORNER KETCH RD | ||||||||
| Address2: | |||||||||
| City: | DOWNINGTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193351227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4848865773 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 850 W LANCASTER AVE | ||||||||
| Address2: | SECOND FLOOR | ||||||||
| City: | BRYN MAWR | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190103220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6105201510 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2013 | ||||||||
| LastUpdateDate: | 10/01/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | SW124656 | PA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.