| NPI | 1992335707 |
|---|---|
| Other Name | CANDY MARIE FULLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: AR R085242) |
| Enumeration Date | 2020-01-21 |
| Last Update Date | 2020-01-21 |