Individual
CHELSEA FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
14892 JETER WAY, CALDWELL, ID 83607-1000
(701) 570-2359
Mailing address
14892 JETER WAY, CALDWELL, ID 83607-1000
(701) 570-2359
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-5957
ID
Other
Enumeration date
12/13/2024
Last updated
12/13/2024
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