Individual
AILEEN FULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
512 BEACH ST, FENTON, MI 48430-3122
(810) 629-4117
Mailing address
8960 ALBANY CT, SALINE, MI 48176-9156
(734) 223-3530
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
MI
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
01/25/2018
Last updated
01/25/2018
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