Organization
PRACTITIONER DIRECT GLOBAL, LLC
Active
Other names
PDG Healthcare & Staffing
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CONSTANCE FULLWOOD DNP/PHNL, PMHNP-BC (CEO/NURSE PRACTITIONER)
(401) 934-3494
Entity
Organization
Contact information
Practice address
1125 WEST ST STE 401, ANNAPOLIS, MD 21401-4198
(410) 934-3494
Mailing address
7831 OLD NORTH CT, CHARLOTTE, NC 28270-2782
(704) 998-1919
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
11/26/2024
Last updated
11/26/2024
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