Individual
ALEXANDRA FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
206 S TYLER ST STE B, COVINGTON, LA 70433-3073
(985) 302-0905
Mailing address
206 S TYLER ST STE B, COVINGTON, LA 70433-3073
(985) 302-0905
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1702
LA
Other
Enumeration date
01/09/2024
Last updated
01/09/2024
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