Individual ProviderCharice FullerCounselorBehavioral Health & Social Service ProvidersPractice Address520 Dudley St, Roxbury, MA 02119-2769(617) 901-6105PECOS EnrollmentBased on the most recent information from CMS, provider Charice Fuller does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1134542327Provider TypeIndividualFull NameFuller, ChariceGenderFemaleSole ProprietorNoEnumeration Date1/24/2014Last Updated1/24/2014Contact InformationPractice LocationPractice Address520 Dudley St, Roxbury, MA 02119-2769Phone(617) 901-6105FaxUnlisted FaxMailing LocationMailing Address520 Dudley St, Roxbury, MA 02119-2769PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101Y00000XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer