NPI 1205348554

Diana Fuller,micou

Practitioner Voluntary or Charitable Agency Kosciusko, MS

Practice location

Address: 825 James H Meredith St, Kosciusko, MS 39090-3161
Phone: (662) 289-3699

Registered specialties

Voluntary or Charitable Agency Primary

Agencies Taxonomy 251V00000X

Other Voluntary or Charitable providers in Mississippi →

Registry record

NPI: 1205348554
Entity type: Individual
Sex (as registered): Female
NPI issued: 26 Oct 2017
Record last updated: 26 Oct 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.