JERRY LEE FULLER

BLOOMFIELD, NJ
NPI1801953716
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker Clinical
(Licence: NJ  44SC05222700)
Enumeration Date2007-01-02
Last Update Date2009-02-02
Business Address
MR. JERRY LEE FULLER LCSW
31 NORTH AVE
BLOOMFIELD, NJ 07003-5516
Phone number: 973-338-8530
Mailing Address
MR. JERRY LEE FULLER LCSW
31 NORTH AVE
BLOOMFIELD, NJ 07003-5516
Phone number: 973-338-8530
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