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1669880670
LORENZA FULLMER
IDAHO FALLS, ID
NPI
1669880670
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist
(Licence: ID SLP 2380)
Enumeration Date
2014-07-23
Last Update Date
2014-09-03
Business Address
LORENZA FULLMER M.S., CCC-SLP
3715 WOODKING DR
IDAHO FALLS, ID 83404-4720
Phone number: 208-529-2255
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Mailing Address
LORENZA FULLMER M.S., CCC-SLP
1212 W 100 S
BLACKFOOT, ID 83221-6035
Phone number: 208-221-0080
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