Individual
MRS. TIFFANY ROSE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ALC
Contact information
Practice address
174 COUNTY ROAD 66, HEFLIN, AL 36264-6287
(256) 452-7024
Mailing address
174 COUNTY ROAD 66, HEFLIN, AL 36264-6287
(256) 452-7024
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
ALC04825
AL
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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