Individual
HEATHER D FULLERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CFY-SLP
Contact information
Practice address
810 E 21ST ST STE 6, CLOVIS, NM 88101-4442
(505) 935-6322
Mailing address
913 LAURELWOOD DR, CLOVIS, NM 88101-3052
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
C3784
NM
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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