Glynis Wikstrom Fullwood, LCSW
Social Worker, Clinical in Chapel Hill, NC. Individual provider (NPI-1).
NPI number1902467350
StatusActive
Last updated in NPPESJun 26, 2019
Details
- NPI
- 1902467350
- Entity type
- Individual (NPI-1)
- Name
- Glynis Wikstrom Fullwood
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 26, 2019
- Last updated
- Jun 26, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | C004458 | NC | Yes |
Practice location
104 S Estes Dr Ste 301gChapel Hill, NC 27514-2848
Phone 919-931-5639
Mailing address
104 S Estes Dr Ste 301gChapel Hill, NC 27514-2848
Phone 919-931-5639
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