Fuller Behavior Program

NPI 1710246293 - Counselor - 101YM0800X

NPI Details
NPI 1710246293
Enumeration Date 05/03/2012
Last Updated 05/03/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name MELVIN MELVIN
Position CEO
Phone (214) 760-9573
Fax
Practice Location
2803 RIVERSIDE PKWY APT 4502
GRAND PRAIRIE TX, 75050-8747, US
Phone (214) 760-9573
Fax
Business Location
2803 RIVERSIDE PKWY APT 4502
GRAND PRAIRIE TX, 75050-8747, US
Phone (214) 760-9573
Fax
Toxanomy
Taxonomy Code 101YM0800X
License State
License Number
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According to our database, Fuller Behavior Program NPI is 1710246293, taxonomy code is 101YM0800X Fuller Behavior Program physically located at 2803 Riverside Pkwy Apt 4502, Grand Prairie TX, 75050-8747. NPI Number 1033115704 has the healthcare provider type.

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1710246293 NPI number is provided on an as is basis without warranty of any kind. 1710246293 is maintained by the National Plan & Provider Enumeration System. The contents of Fuller Behavior Program are for informational purposes only.