Leslie Alaine Fuller | Memphis, TN • PECOS Search

Leslie Alaine Fuller

Social Worker

Behavioral Health & Social Service Providers

1030 Jefferson Ave 614/116a3, Memphis, TN 38104-2193

PECOS Enrollment

Based on the most recent information from CMS, provider Leslie Alaine 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 2 days ago.

Profile Details

Provider ID
1942213640
Provider Type
Individual
Full Name
Fuller, Leslie Alaine
Title
Ms.
Credential
LCSW

Gender
Female
Sole Proprietor
No
Enumeration Date
8/14/2006
Last Updated
7/8/2007

Contact Information

Practice Location

1030 Jefferson Ave 614/116a3, Memphis, TN 38104-2193

(901) 577-7518

Mailing Location

1030 Jefferson Ave 614/116a3, Memphis, TN 38104-2193

(901) 577-7518

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 0000000200 Tennessee