MR. Jerry Lee Fuller JR., LCSW
NPI #1801953716 in Bloomfield, New Jersey
Provider Information
- NPI Number
- 1801953716
- Entity Type
- Individual
- Name
- MR. Jerry Lee Fuller JR., LCSW
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Social Worker - Clinical
- Credential
- LCSW
- Enumeration Date
- Jan 2, 2007
- Last Updated
- Feb 2, 2009
Practice Location
- Address
- 31 NORTH AVE
- City
- Bloomfield
- State
- New Jersey
- ZIP Code
- 07003-5516
- Phone
- (973) 338-8530
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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