Individual
ALLEN FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9500 MEDICAL CENTER DR STE 104, LARGO, MD 20774-3703
(240) 334-4394
Mailing address
9500 MEDICAL CENTER DR STE 104, LARGO, MD 20774-3703
(240) 334-4394
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
AC1689
MD
Other
Enumeration date
08/30/2024
Last updated
08/30/2024
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