Fuller, Brian Jay
Fuller, Brian Jay is an sole proprietor health care provider with primary practice located at 1662 E Centre Ave , Portage MI 49002-4410. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Fuller, Brian Jay can be contacted via phone (269) 321-8564.Contact Information
Primary practice address
1662 E Centre Ave
Portage MI 49002-4410
Phone: (269) 321-8564
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 6301013172 | Michigan |
Profile Details
| NPI number | 1942258595 |
|---|---|
| LBN Legal business name | Fuller, Brian Jay |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 5th, 2006 |
| Last updated | Jun 19th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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