Lance Fuller

NPI #1386107332 in Bryan, Texas

Provider Information

NPI Number: 1386107332
Entity Type: Individual
Name: Lance Fuller
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Professional
Enumeration Date: Apr 8, 2019
Last Updated: Apr 8, 2019

Practice Location

Address: 3370 S TEXAS AVE STE B
City: Bryan
State: Texas
ZIP Code: 77802-3127
Phone: (979) 595-1700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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