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1770357089
SHANE LUNDY FULLER
CHESAPEAKE, OH
NPI
1770357089
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH CDCA.186291)
Enumeration Date
2023-11-08
Last Update Date
2023-11-08
Business Address
SHANE LUNDY FULLER
517 3RD AVE
CHESAPEAKE, OH 45619-1036
Phone number: 740-451-1455
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Mailing Address
SHANE LUNDY FULLER
11374 COUNTY ROAD 1
CHESAPEAKE, OH 45619-7126
Phone number: 681-268-7929
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