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1417553264
CHAD CARL FULFORD
ALBUQUERQUE, NM
NPI
1417553264
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NM CSA0213151)
Enumeration Date
2020-12-08
Last Update Date
2020-12-08
Business Address
CHAD CARL FULFORD
630 HAINES AVE NW
ALBUQUERQUE, NM 87102-1226
Phone number: 505-268-5611
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Mailing Address
CHAD CARL FULFORD
630 HAINES AVE NW
ALBUQUERQUE, NM 87102-1226
Phone number: 505-268-5611
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