Individual
THERESA S. FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15 W PROSPECT ST, EAST BRUNSWICK, NJ 08816-2161
(732) 254-0600
Mailing address
28 ROCKY HILL RD, PRINCETON, NJ 08540-9469
(732) 995-7807
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37AC00514400
NJ
Other
Enumeration date
08/29/2022
Last updated
08/29/2022
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