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General NPI Number Information
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NPI Number | 1427676956
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Entity Type | Individual
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Provider Name | HANNAH FULLER
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Gender | Female
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Dates
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Enumeration Date | 07/10/2020
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Last Update Date | 07/10/2020
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Provider Practice Location Address
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Address Line | 7161 COLUMBIA GATEWAY DR STE A
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City | COLUMBIA
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State | MD
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Zip | 21046-2148
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Country | US
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Telephone | 410-872-1050
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Fax |
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Provider Business Mailing Address
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Address Line | 237 S CASTLE ST
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City | BALTIMORE
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State | MD
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Zip | 21231-2602
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Country | US
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Telephone | 410-872-1050
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 23209
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License Number State | MD
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