Individual
AVA FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
820 DUKE AVE STE A, WARNER ROBINS, GA 31093-2684
(478) 225-3882
Mailing address
1321 MURFREESBORO PIKE STE 702, NASHVILLE, TN 37217-2679
(615) 695-2277
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-82896
GA
Other
Enumeration date
04/11/2019
Last updated
04/11/2019
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