| NPI | 1427017573 |
|---|---|
| Professional Name | MICK FULLER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: UT 5329261-6010) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 5329261-6006) |
| Enumeration Date | 2006-03-18 |
| Last Update Date | 2009-11-09 |