Fullerton, Shane R

Fullerton, Shane R is an individual health care provider with primary practice located at 75-5699 Alii Dr Ste E , Kailua Kona HI 96740-3112. He recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as his primary health care specialty. Fullerton, Shane R can be contacted via phone (443) 226-4939.

Contact Information

Primary practice address
75-5699 Alii Dr Ste E Kailua Kona HI 96740-3112
Phone: (443) 226-4939
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X

Profile Details

NPI number 1063862852
LBN Legal business name Fullerton, Shane R
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2016
Last updated Jun 14th, 2016 - about 10 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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