| Fuller Behavior Program | |
|
2803 Riverside Pkwy Apt 4502 Grand Prairie TX 75050-8747 | |
| (214) 760-9573 | |
| Not Available |
| Full Name | Fuller Behavior Program |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2803 Riverside Pkwy Apt 4502, Grand Prairie, Texas |
| Authorized Official Name and Position | Melvin Fuller (CEO) |
| Authorized Official Contact | 2147609573 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fuller Behavior Program 2803 Riverside Pkwy Apt 4502 Grand Prairie TX 75050-8747 Ph: (214) 760-9573 | Fuller Behavior Program 2803 Riverside Pkwy Apt 4502 Grand Prairie TX 75050-8747 Ph: (214) 760-9573 |
| NPI Number | 1710246293 |
|---|---|
| Provider Enumeration Date | 05/03/2012 |
| Last Update Date | 05/03/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710246293 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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