Individual
MR. JOHN C FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
611 PENNSYLVANIA AVE SE # 415, WASHINGTON, DC 20003-4303
(202) 643-6018
Mailing address
3350 TOLEDO TER APT 356, HYATTSVILLE, MD 20782-3259
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
27102
MD
Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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