Individual
BRIDGET FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1145 OLD COLONY LINE RD, DALE, TX 78616-2167
(737) 248-7042
Mailing address
1145 OLD COLONY LINE RD, DALE, TX 78616-2167
(737) 248-7042
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
TX
Other
Enumeration date
08/06/2026
Last updated
08/06/2026
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