Individual
DR. MEREDITH ANN FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
123 W CONCORD ST, APT. 2, BOSTON, MA 02118-1507
(617) 838-6035
Mailing address
PO BOX 350, WEST FALMOUTH, MA 02574-0350
(617) 838-6035
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7368
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W05847
BCBS
MA
Enumeration date
11/08/2007
Last updated
11/08/2007
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