Individual
MR. ROSEVELT JOSEPH FLUELLEN
Active
Individual
MR. ROSEVELT JOSEPH FLUELLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
1042
ND
Other
Enumeration date
06/14/2009
Last updated
06/14/2009
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