Individual
MRS. MELISSA S FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CGC
Contact information
Practice address
525 BOB PETERS GRV STE 309, COLORADO SPRINGS, CO 80909
(719) 365-9867
(719) 365-9520
Mailing address
525 BOB PETERS GRV STE 309, COLORADO SPRINGS, CO 80909-4533
(719) 365-9867
(719) 365-9520
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
NO LICENSE
MO
Other
Enumeration date
09/17/2012
Last updated
05/30/2018
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