Fuller, Laura L

Fuller, Laura L is an individual health care provider with primary practice located at 200 Hawkins Dr , Iowa City IA 52242-1009. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Fuller, Laura L can be contacted via phone (319) 353-8978.

Contact Information

Primary practice address
200 Hawkins Dr Iowa City IA 52242-1009
Fax: (319) 384-8843
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 316 Montana
Behavioral Health & Social Service Providers / Clinical 103TC0700X 001276 Iowa

Profile Details

NPI number 1982813150
LBN Legal business name Fuller, Laura L
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2007
Last updated Oct 3rd, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982813150 NPPES
Montana MEDICAID 0492099

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