FULLER BEHAVIOR PROGRAM NPI 1710246293

NPI Information

NPI: 1710246293
Provider Name: FULLER BEHAVIOR PROGRAM

Doing Business As: FULLER BEHAVIOR PROGRAM

Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
2803 RIVERSIDE PKWY APT 4502
GRAND PRAIRIE, TX
ZIP 75050
Phone: (214) 760-9573
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FULLER BEHAVIOR PROGRAM is a mental health counselor in Grand Prairie, TX. FULLER BEHAVIOR PROGRAM NPI is 1710246293. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Fuller Behavior Program.

The provider's business location address is:

2803 RIVERSIDE PKWY APT 4502
GRAND PRAIRIE, TX
ZIP 75050-747
Phone: (214) 760-9573

The provider's authorized official is Melvin Fuller .
The authorized official title is Ceo and has the following contact phone number (214) 760-9573.

The enumeration date for this NPI number is 5/3/2012 and was last updated on 5/3/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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