| Doctor Name: | MR. JAMES ADAMS FULLILOVE INC |
| NPI Number: | 1669537023 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | 1693 |
| Business Practice Address: | 3218 Line Ave Suite 222 Shreveport, LA - 711044261 |
| Business Phone Number: | 3188681819 |
| Business Fax Number: | 8664904806 |
| Mailing Address: | 3218 Line Ave, Suite 222 SHREVEPORT |
| State: | LA |
| Postal Code: | 711044261 |
| Phone Number: | 3187340576 |
| Fax Number: | 8664904806 |
| NPI Enumeration Date: | 12/26/2006 |
| NPI Last Update Date: | 01/13/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 1693 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |