Individual
KATHERINE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8551 RIXLEW LN, MANASSAS, VA 20109-4277
(866) 727-8274
Mailing address
8551 RIXLEW LN, MANASSAS, VA 20109-4277
(866) 727-8274
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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