Individual
ALEXANDER D FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
824 PINE ST STE 106, LOUISVILLE, CO 80027-1836
(720) 352-3594
Mailing address
824 PINE ST STE 106, LOUISVILLE, CO 80027-1836
(720) 352-3594
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
084-520493
EMPLOYER IDENTIFICATION
CO
Enumeration date
03/06/2007
Last updated
03/21/2025
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