| NPI | 1982469722 |
|---|---|
| Other Name | ALIA BONNIE FULLETON |
| Entity Type | Organization |
| Authorized Contact | ALIA FULLETON Owner 541-249-5111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2024-02-20 |
| Last Update Date | 2024-02-20 |