BRIAN JAY FULLER

PORTAGE, MI
NPI1942258595
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy103T00000X Psychologist
(Licence: MI  6301013172)
Enumeration Date2006-05-05
Last Update Date2012-06-19
Business Address
Mr. BRIAN JAY FULLER Ph.D.
1662 E CENTRE AVE
PORTAGE, MI 49002-4410
Phone number: 269-321-8564
Mailing Address
Mr. BRIAN JAY FULLER Ph.D.
5340 HOLIDAY TER
KALAMAZOO, MI 49009-2196
Phone number: 269-321-8564
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