Individual
CHRYSTAL TARRYN FULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
4301 W MARKHAM ST # 589, LITTLE ROCK, AR 72205-7101
(501) 526-8284
Mailing address
4301 W MARKHAM ST # 589, LITTLE ROCK, AR 72205-7101
(501) 526-8284
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
19-32AP-PL
AR
Other
Enumeration date
05/20/2016
Last updated
08/27/2021
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