Individual
ASHLEY GRACE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
251 PLAZA DRIVE SUITE C, OVIEDO, FL 32765
(407) 694-3603
Mailing address
251 PLAZA DRIVE SUITE C, OVIEDO, FL 32765
(407) 694-3603
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
4265
KS
235Z00000X
Speech-Language Pathologist
Primary
SA16690
FL
Other
Enumeration date
11/27/2018
Last updated
11/27/2018
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