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1679013296
JEFFREY FULLER
BANGOR, ME
NPI
1679013296
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ME CAC6232)
Enumeration Date
2017-03-01
Last Update Date
2017-03-01
Business Address
Mr. JEFFREY FULLER CADC
98 CUMBERLAND ST
BANGOR, ME 04401-5234
Phone number: 207-941-1600
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Mailing Address
Mr. JEFFREY FULLER CADC
98 CUMBERLAND ST
BANGOR, ME 04401-5234
Phone number: 207-941-1600
Copy
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