Individual
QUINCY FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
508 UPLAND ST, KENAI, AK 99611-8026
(907) 953-3491
Mailing address
508 UPLAND ST, KENAI, AK 99611-8026
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
AK
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
AK
Other
Enumeration date
07/19/2023
Last updated
06/19/2025
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