| NPI | 1356473409 |
|---|---|
| Professional Name | STACY L FULLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 103T00000X Psychologist (Licence: ND 404) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2008-04-20 |