Individual
DR. STEPHANIE M FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3515 BROADWAY AVE., YANKTON, SD 57078-7600
(605) 668-3100
(605) 668-3460
Mailing address
PO BOX 7600, 3515 BROADWAY AVE., YANKTON, SD 57078-7600
(605) 668-3100
(605) 668-3460
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
427
SD
Other
Enumeration date
02/13/2013
Last updated
02/13/2013
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