Anna R Fullmer, MSSW, LCSW | |
400 S Townline Rd, Wautoma, WI 54982-6922 | |
(920) 787-5514 | |
Not Available |
Full Name | Anna R Fullmer |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 400 S Townline Rd, Wautoma, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1306897467 | NPI | - | NPPES |
39797500 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 6573-123 (Wisconsin) | Primary |
Entity Name | La Clinica De Los Campesinos, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1790786929 PECOS PAC ID: 8729996574 Enrollment ID: O20040806000058 |
Mailing Address | Practice Location Address |
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Anna R Fullmer, MSSW, LCSW 400 S Townline Rd, Wautoma, WI 54982-6922 Ph: (920) 787-5514 | Anna R Fullmer, MSSW, LCSW 400 S Townline Rd, Wautoma, WI 54982-6922 Ph: (920) 787-5514 |
Laurinda S Wittenhagen, LCSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 230 Park St, Wautoma, WI 54982 Phone: 920-787-6550 Fax: 920-787-0421 | |
Jennifer A Ward, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 230 Park St, Wautoma, WI 54982 Phone: 920-787-6618 Fax: 920-787-6670 | |
Clara L Voigtlander, LCSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 230 Park St, Wautoma, WI 54982 Phone: 920-787-6550 Fax: 920-787-0421 | |
Megan Schwobe, APSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 400 S Townline Rd, Wautoma, WI 54982 Phone: 920-787-5514 Fax: 920-787-4737 |