Individual
CHAD CARL FULFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2907 SAN MATEO BLVD NE, ALBUQUERQUE, NM 87110-3156
(505) 636-6100
Mailing address
2907 SAN MATEO BLVD NE, ALBUQUERQUE, NM 87110-3156
(505) 636-6100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CSA0213151
NM
Other
Enumeration date
12/08/2020
Last updated
11/30/2024
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