Individual
CHARLES FULLER, III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
319 BEECH ST, HOLYOKE, MA 01040-3925
(413) 540-1155
Mailing address
745 STATION RD, AMHERST, MA 01002-3420
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/03/2009
Last updated
03/03/2009
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