Individual
DR. LAURA ASHLEY FULLER-POLHAMUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
134 W END AVE, SOMERVILLE, NJ 08876-1816
(908) 333-4646
Mailing address
134 W END AVE, SOMERVILLE, NJ 08876-1816
(908) 333-4646
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5909
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/10/2009
Last updated
03/15/2019
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