Individual
REBECCA SUE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
132 E BROADWAY STE 301, EUGENE, OR 97401-3154
(541) 579-8644
Mailing address
1945 HARVEY RD, COTTAGE GROVE, OR 97424-1286
(503) 803-4867
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C3586
OR
101YP2500X
Professional Counselor
Primary
C3586
OR
Other
Enumeration date
01/28/2020
Last updated
04/10/2026
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