Individual
KRISTIE M FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
5524 RIVER OAKS DR, TITUSVILLE, FL 32780-7037
(321) 209-2332
Mailing address
5524 RIVER OAKS DR, TITUSVILLE, FL 32780-7037
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
IMH18176
FL
101YP2500X
Professional Counselor
Primary
MH20191
FL
Other
Enumeration date
06/19/2020
Last updated
11/17/2023
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