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NINA VANBROCKLIN FULLER LCPC-C

Professional >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1124423413

Individual Registrant:
 NINA VANBROCKLIN FULLER LCPC-C
Gender: F
Not Sole Proprietor

Location and contact information for practice:
335 LITTLE FALLS RD  HOLLIS CENTER, ME 04042-3921 US
Tel: 207-650-8963  Fax: --

Contact information for business:
335 LITTLE FALLS RD  HOLLIS CENTER, ME 04042-3921 US
Tel: 207-650-8963  Fax: --

Registration Information:
NPI: 1124423413
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YP2500XBehavioral Health & Social Service Providers
Counselor
Professional
MEXL4326

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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