Individual
RENEE H FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
2150 LEXINGTON RD, SUITE G, RICHMOND, KY 40475-7924
(859) 333-8147
(877) 665-7294
Mailing address
112 PRIMROSE CIR, RICHMOND, KY 40475-6833
(859) 623-6383
(877) 665-7294
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
KY 2579
KY
Other
Enumeration date
09/09/2011
Last updated
09/09/2011
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