| NPI | 1710246293 |
|---|---|
| Doing Business As | FULLER BEHAVIOR PROGRAM |
| Entity Type | Organization |
| Authorized Contact | MELVIN FULLER CEO 214-760-9573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2012-05-03 |