Individual
SARA LEU FULLINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
610 E OLDEN ST, WEST PLAINS, MO 65775-3334
(417) 256-6155
Mailing address
1950 S SCENIC AVE APT L102, SPRINGFIELD, MO 65807-2295
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2008012497
MO
Other
Enumeration date
03/29/2021
Last updated
03/29/2021
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