Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. BRIAN JAY FULLER, PH.D.
Active Sole ProprietorMR. BRIAN JAY FULLER, PH.D. is a Psychologist healthcare provider located in PORTAGE, Michigan. NPI 1942258595 is currently active in the NPPES registry. Verify at CMS.
Psychologist · PORTAGE, MI
Registration Details
- NPI Number
- 1942258595
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 5, 2006 (20.234678639324 yrs)
- Last Updated
- Jun 19, 2012
- License
-
6301013172 (MI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1662 E CENTRE AVEPORTAGE, MI, 490024410Browse MI providers · Browse ZIP 49002
- Phone
- 2693218564
- Primary Specialty
-
Psychologist
103T00000X
Other Psychologist Providers in PORTAGE, MI
| Name | Credential | NPI |
|---|---|---|
| DR. JAMES DARRELL COWART | PH.D | 1598746778 |
| DR. TIMOTHY JAMES HOWARD | ED.D. | 1396721247 |
| MICHAEL V BLOOM | PHD | 1477530392 |
| PATRICIA SHULL-BLOOD | LLP | 1033169008 |
| STEPHANIE STEWART | LLP | 1386694909 |
| AIJA LUBAVS | MA | 1871547653 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.