Individual
RICHARD DANIEL FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2600 DENALI ST, SUITE 450, ANCHORAGE, AK 99503-2746
(907) 561-0552
(907) 561-0562
Mailing address
PO BOX 92303, ANCHORAGE, AK 99509-2303
(907) 561-0552
(907) 561-0562
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
441
AK
103T00000X
Psychologist
441
AK
103TA0700X
Adult Development & Aging Psychologist
441
AK
103TB0200X
Cognitive & Behavioral Psychologist
441
AK
103TC0700X
Clinical Psychologist
441
AK
103TC2200X
Clinical Child & Adolescent Psychologist
441
AK
103TF0200X
Forensic Psychologist
441
AK
103TM1800X
Intellectual & Developmental Disabilities Psychologist
441
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
441
PSYCHOLOGIST LICENSE
AK
01
—
51478
NATIONAL REGISTER-PSYCHOL
DC
05
—
PS04411
—
AK
Enumeration date
08/05/2006
Last updated
03/22/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us