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1780150011
MARTIA JERONDA FULLER
CHARLOTTE, NC
NPI
1780150011
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor Professional
(Licence: NC A14117)
Enumeration Date
2018-10-14
Last Update Date
2020-01-03
Business Address
MARTIA JERONDA FULLER
8401 MEDICAL PLAZA DR STE 360
CHARLOTTE, NC 28262-8700
Phone number: 704-208-4458
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Mailing Address
MARTIA JERONDA FULLER
204 SYCAMORE ST
OXFORD, NC 27565-3625
Phone number: 919-339-0649
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