Individual
MRS. LAUREN ASHLEY FULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP, MBA
Contact information
Practice address
103 NORTH ST, BRISTOL, VA 24201-3201
(276) 642-7900
Mailing address
103 NORTH ST, BRISTOL, VA 24201-3201
(276) 642-7900
(276) 642-8091
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202006003
VA
235Z00000X
Speech-Language Pathologist
4084
TN
Other
Enumeration date
02/06/2014
Last updated
10/09/2020
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