Individual
AMY LYNN FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
2011 BROADWAY ST STE 130, PEARLAND, TX 77581-5945
(281) 997-8509
Mailing address
4121 OLD BEAUMONT HWY, SILSBEE, TX 77656-6473
(406) 656-8335
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
108990
TX
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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