Vivian Fuller

NPI #1295365112 in Caruthersville, Missouri

Provider Information

NPI Number: 1295365112
Entity Type: Individual
Name: Vivian Fuller
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jan 20, 2020
Last Updated: Jan 20, 2020

Practice Location

Address: 915 HIGHWAY 84 W
City: Caruthersville
State: Missouri
ZIP Code: 63830-8113
Phone: (573) 333-5875

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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