Individual
CYNTHIA FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 SOMERBY DR, ALPHARETTA, GA 30009-8780
(678) 339-3542
Mailing address
100 SOMERBY DR, ALPHARETTA, GA 30009-8780
(678) 339-3542
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP000650
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLP000650
SPEECH THERAPY LICENSE
GA
Enumeration date
12/29/2009
Last updated
12/29/2009
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