Individual
MS. FAITH B FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
190 WESTBROOK RD, CHILD & FAMILY AGENCY, ESSEX, CT 06426
(860) 767-0147
(860) 767-0148
Mailing address
199 HALL AVE, WALLINGFORD, CT 06492
(203) 284-9614
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
001297
CT
Other
Enumeration date
07/31/2006
Last updated
07/08/2007
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