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Individual
MICHAEL EUGENE FULLER
Active
Individual
MICHAEL EUGENE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
IMH 5580
FL
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/11/2010
Last updated
04/11/2017
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