Individual
CHAUNCEY FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2775 STATE ROUTE 39, SHELBY, OH 44875-9466
(419) 747-3322
Mailing address
2775 STATE ROUTE 39, SHELBY, OH 44875-9466
(419) 747-3322
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.192941
OH
Other
Enumeration date
07/16/2025
Last updated
07/16/2025
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