Organization
FULLER LIVING & ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER ROSE FULLER (LMFT/PRESIDENT)
(763) 647-8188
Entity
Organization
Contact information
Practice address
10077 DOGWOOD ST NW, STE 206, COON RAPIDS, MN 55448
(763) 647-8188
Mailing address
7700 SUNWOOD DR NW, 114, RAMSEY, MN 55303
(763) 647-8188
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/16/2014
Last updated
09/02/2016
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