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1144917501
JACQUELINE L FULLER
BALTIMORE, MD
NPI
1144917501
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MD ADT2363)
Enumeration Date
2023-04-18
Last Update Date
2023-04-18
Business Address
JACQUELINE L FULLER
821 N EUTAW ST STE 201
BALTIMORE, MD 21201-6301
Phone number: 410-225-9185
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Mailing Address
JACQUELINE L FULLER
27 TIMBER GROVE RD
OWINGS MILLS, MD 21117-1820
Phone number: 443-965-8726
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