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Individual

MS. ELLEN-BETH FULLWOOD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS CCC-SLP

Contact information

Practice address
15114 CLOVERDALE DR, FORT MYERS, FL 33919-8308
(239) 410-2629
(309) 410-2629
Mailing address
15114 CLOVERDALE DR, FORT MYERS, FL 33919-8308
(239) 410-2629
(309) 410-2629

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA9064
FL

Other

Enumeration date
09/24/2008
Last updated
09/24/2008
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