Individual
EMMANUEL FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6817 STORCH CT, LANHAM, MD 20706-2189
(240) 898-6203
Mailing address
6817 STORCH CT, LANHAM, MD 20706-2189
(240) 898-6203
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
02/06/2025
Last updated
02/06/2025
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