Individual
JENNIFER FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1045 JAMES ST, SYRACUSE, NY 13203-2730
(315) 472-4471
(315) 472-1759
Mailing address
1045 JAMES ST, SYRACUSE, NY 13203-2730
(315) 472-4471
(315) 472-1759
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/10/2008
Last updated
11/17/2016
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