Individual
MRS. KRISTEN FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
505 HERRINGTON DR, SPRINGHILL, LA 71075-2205
(318) 539-5663
Mailing address
491 PAUL ODOM RD, HAYNESVILLE, LA 71038-6534
(504) 912-6352
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4336
LA
Other
Enumeration date
09/13/2023
Last updated
09/13/2023
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