Individual
ASHLEY M FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SPEECH PATHOLIGIST
Contact information
Practice address
456 BROAD ST, WAVERLY, NY 14892-1445
(607) 948-4047
(607) 565-2200
Mailing address
456 BROAD ST, WAVERLY, NY 14892-1445
(607) 948-4047
(607) 565-2200
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
021178-1
NY
Other
Enumeration date
09/28/2011
Last updated
09/28/2011
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