Individual
CANDY FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
189 N PLANO RD STE 100, RICHARDSON, TX 75081-8001
(469) 828-8252
Mailing address
189 N PLANO RD STE 100, RICHARDSON, TX 75081-8001
(469) 828-8252
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-259257
TX
Other
Enumeration date
06/07/2023
Last updated
06/07/2023
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