| Doctor Name: | MS. FAITH B FULLER |
| NPI Number: | 1083620926 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 001297 |
| Business Practice Address: | 190 Westbrook Rd Child & Family Agency Essex, CT - 06426 |
| Business Phone Number: | 8607670147 |
| Business Fax Number: | 8607670148 |
| Mailing Address: | 199 Hall Ave, WALLINGFORD |
| State: | CT |
| Postal Code: | 06492 |
| Phone Number: | 2032849614 |
| Fax Number: | |
| NPI Enumeration Date: | 07/31/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 001297 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |