Individual
ALEX FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3361 36TH ST SE, KENTWOOD, MI 49512-2809
(616) 942-2522
Mailing address
3361 36TH ST SE, KENTWOOD, MI 49512-2809
(616) 942-2522
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/02/2026
Last updated
01/02/2026
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