Sonya Latrice Fuller | Willoughby, OH • PECOS Search

Sonya Latrice Fuller

Social Worker

Behavioral Health & Social Service Providers

38616 Fairway Glenn Blvd, Willoughby, OH 44094-7188

PECOS Enrollment

Based on the most recent information from CMS, provider Sonya Latrice Fuller does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1275133068
Provider Type
Individual
Full Name
Fuller, Sonya Latrice
Title
Mrs.
Credential
MSW, LISW-S

Gender
Female
Sole Proprietor
Yes
Enumeration Date
10/29/2020
Last Updated
10/29/2020

Contact Information

Practice Location

38616 Fairway Glenn Blvd, Willoughby, OH 44094-7188

Unlisted Fax

Mailing Location

38616 Fairway Glenn Blvd, Willoughby, OH 44094-7188

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License I.1600316-SUPV Ohio