Organization
FAMILY DEVELOPMENT ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORE FULLER PH.D. (PSYCHOLOGIST)
(202) 955-6381
Entity
Organization
Contact information
Practice address
4115 WISCONSIN AVE NW STE 203, WASHINGTON, DC 20016-2849
(202) 955-6381
(202) 232-2634
Mailing address
4115 WISCONSIN AVE NW STE 203, WASHINGTON, DC 20016-2849
(202) 955-6381
(202) 232-2634
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY1827
DC
Other
Enumeration date
05/10/2016
Last updated
05/10/2016
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