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1801019575
BRIAN CHARLES FULLER
GLEN BURNIE, MD
NPI
1801019575
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MD SC1198)
Enumeration Date
2007-04-11
Last Update Date
2007-07-08
Business Address
Mr. BRIAN CHARLES FULLER MS CSGAD
122 LANGLEY ROAD NORTH SUITE B
GLEN BURNIE, MD 21060
Phone number: 410-222-0100
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Mailing Address
Mr. BRIAN CHARLES FULLER MS CSGAD
122 LANGLEY ROAD NORTH SUITE B
GLEN BURNIE, MD 21060
Phone number: 410-222-0100
Copy
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