Individual
AMBER FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7143 BRAY RD, HAYES, VA 23072-3433
(757) 262-7824
Mailing address
7143 BRAY RD, HAYES, VA 23072-3433
(757) 262-7824
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202005886
VA
Other
Enumeration date
02/15/2017
Last updated
02/15/2017
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