Individual
DR. LISA BETH FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
2627 NE 203RD ST, SUITE 214, MIAMI, FL 33180-1900
(786) 202-0474
Mailing address
2627 NE 203RD ST, SUITE 214, MIAMI, FL 33180-1900
(786) 202-0474
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY6682
FL
Other
Enumeration date
09/24/2006
Last updated
09/04/2013
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