DR. Mickey Joe Fuller, MA, MS, PSY.D.

NPI #1427017573 in Moab, Utah

Provider Information

NPI Number: 1427017573
Entity Type: Individual
Name: DR. Mickey Joe Fuller, MA, MS, PSY.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Professional
Credential: MA, MS, PSY.D.
Enumeration Date: Mar 18, 2006
Last Updated: Nov 9, 2009

Practice Location

Address: 198 E CENTER ST
City: Moab
State: Utah
ZIP Code: 84532-2430
Phone: (435) 259-6131

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Professional — Professional	101YP2500X	Primary

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