Individual
STEFANIE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
415 N 26TH ST STE 102, LAFAYETTE, IN 47904-2855
(765) 446-6620
Mailing address
415 N 26TH ST STE 102, LAFAYETTE, IN 47904-2855
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/30/2021
Last updated
09/30/2021
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