Individual
MR. JEFFREY FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
98 CUMBERLAND ST, BANGOR, ME 04401-5234
(207) 941-1600
(207) 941-1608
Mailing address
98 CUMBERLAND ST, BANGOR, ME 04401-5234
(207) 941-1600
(207) 941-1608
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAC6232
ME
Other
Enumeration date
03/01/2017
Last updated
03/01/2017
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