Shane Fuller

NPI #1497112114 in Wilton, California

Provider Information

NPI Number
1497112114
Entity Type
Individual
Name
Shane Fuller
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Counselor - Addiction (Substance Use Disorder)
Enumeration Date
Jan 26, 2016
Last Updated
Jan 26, 2016

Practice Location

Address
11255 MANN RD
City
Wilton
ZIP Code
95693-9712
Phone
(916) 606-0027

Specialties & Taxonomy Codes

Specialty
Counselor - Addiction (Substance Use Disorder)Addiction (Substance Use Disorder)

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