Desirae L Fuller
NPI #1992331136 in Roswell, New Mexico
Provider Information
- NPI Number
- 1992331136
- Entity Type
- Individual
- Name
- Desirae L Fuller
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Behavior Technician
- Enumeration Date
- Mar 19, 2020
- Last Updated
- Mar 24, 2020
Practice Location
- Address
- 500 W BRASHER RD TRLR 103
- City
- Roswell
- State
- New Mexico
- ZIP Code
- 88203-5303
- Phone
- (575) 840-4359
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Technician |
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