Most Relevant Information
Provider Data
| NPI Number: | 1003581067 |
| Provider Name: | EMMA FULLER |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/12/2021 |
| Last Updated: | 08/12/2021 |
Provider Practice Location
2740 N HARBOR CITY BLVD
MELBOURNE
FL
329356291
Practice Location Phone/Fax
| Phone: | 3216226884 |
| Fax: |
Provider Mailing Location
1486 DONEGAL DR
MELBOURNE
FL
329406057
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |