| Doctor Name: | DEANNE MELOR MATHESON FULLER |
| NPI Number: | 1336332642 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW, MSW |
| License Number: | 40418 |
| Business Practice Address: | 415 Reservation Dr Harker Heights, TX - 765487466 |
| Business Phone Number: | 2546901283 |
| Business Fax Number: | |
| Mailing Address: | 415 Reservation Dr, HARKER HEIGHTS |
| State: | TX |
| Postal Code: | 765487466 |
| Phone Number: | 2546901283 |
| Fax Number: | |
| NPI Enumeration Date: | 08/20/2007 |
| NPI Last Update Date: | 08/20/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 40418 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |