Individual
DR. TERRENCE DAVID FULLERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
14010 NATIA MANOR DRIVE, NORTH POTOMAC, MD 20878
(240) 515-4834
Mailing address
14010 NATIA MANOR DRIVE, NORTH POTOMAC, MD 20878
(240) 515-4834
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
02250
MD
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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