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1073347076
ALLEN FULLER
LARGO, MD
NPI
1073347076
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MD AC1689)
Enumeration Date
2024-08-30
Last Update Date
2024-08-30
Business Address
ALLEN FULLER
9500 MEDICAL CENTER DR STE 104
LARGO, MD 20774-3703
Phone number: 240-334-4394
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Mailing Address
ALLEN FULLER
9500 MEDICAL CENTER DR STE 104
LARGO, MD 20774-3703
Phone number: 240-334-4394
Copy
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