Individual
JANICE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
159 WATERHOLE RD, COLCHESTER, CT 06415-2336
(860) 267-8121
Mailing address
159 WATERHOLE RD, COLCHESTER, CT 06415-2336
(860) 267-8121
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/21/2011
Last updated
12/21/2011
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