Individual
AMY M FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1380 PANTHEON WAY, #310, SAN ANTONIO, TX 78232
(210) 393-4650
(210) 694-4600
Mailing address
1380 PANTHEON WAY, #310, SAN ANTONIO, TX 78232
(210) 393-4650
(210) 694-4600
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
17295LPC
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
456168
VALUE OPTIONS
—
01
—
5169LC
BCBS
—
Enumeration date
08/23/2006
Last updated
07/08/2007
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