| NPI | 1487665576 |
|---|---|
| Former Name | JENNIFER A FULLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA10025) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 102289) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2009-08-19 |