Individual
CARINA LYNN FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
100 HANCOCK ST STE 901, QUINCY, MA 02171-1745
(508) 927-1176
Mailing address
321 WARREN ST, NEEDHAM, MA 02492-2946
(617) 763-0967
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
221700000X
Art Therapist
—
—
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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