Individual provider · Type 1 NPI
Shane Fuller
Addiction (Substance Use Disorder) Counselor · Wilton, CA
NPI number
1497112114
Active
Practice location
11255 Mann Rd
Wilton, CA 95693-9712
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | None listed |
Addiction (Substance Use Disorder) Counselor: Definition to come...
About NPI 1497112114
Shane Fuller's National Provider Identifier is 1497112114, issued on Jan 26, 2016. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Wilton, CA. The record was last updated on Jan 26, 2016.