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Individual

TAMALA FULLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
860 TIFFANY BLVD, ROCKY MOUNT, NC 27804-1809
(252) 442-8100
(252) 442-9798
Mailing address
4300 110 SAPPHIRE COURT, GREENVILLE, NC 27834-9011
(252) 830-7540
(252) 413-0932

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
09/24/2008
Last updated
09/24/2008
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