Most Relevant Information
Provider Data
| NPI Number: | 1003230475 |
| Provider Name: | LAUREN ASHLEY FULLEN M.S. CCC-SLP, MBA |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 4084 |
Most Important Dates
| Enumeration Date: | 02/06/2014 |
| Last Updated: | 10/09/2020 |
Provider Practice Location
103 NORTH ST
BRISTOL
VA
242013201
Practice Location Phone/Fax
| Phone: | 2766427900 |
| Fax: |
Provider Mailing Location
103 NORTH ST
BRISTOL
VA
242013201
Provider Mailing Phone/Fax
| Phone: | 2766427900 |
| Fax: | 2766428091 |