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NPI Code Detail

MEDICARE: VALERIA FULLER

MEDICARE:   VALERIA  FULLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1578324307
Entity Type Code : Individual
Provider Name (Legal Business Name) : VALERIA FULLER
Provider Business Mailing Address
First Line : 28427 SUNRISE VIEW DR
Second Line :
City : SPRING
State : TX
Zip : 77386-4939
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 28427 SUNRISE VIEW DR
Second Line :
City : SPRING
State : TX
Zip : 77386-4939
Country : US
Telephone Number : 832-577-5121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2024
Last Update Date : 01/18/2024

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Directions to “ VALERIA FULLER ” Practice Location

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