Individual
BARBARA FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
125 CHESHIRE RD, DAYTONA BEACH, FL 32118
(386) 871-5498
Mailing address
125 CHESHIRE RD, DAYTONA BEACH, FL 32118-5403
(386) 871-5498
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-18-6930
OH
222Q00000X
Developmental Therapist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
07/14/2016
Last updated
07/02/2025
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