Fuller, Maranda Vandyke

Fuller, Maranda Vandyke is an individual health care provider with primary practice located at 628 Lake St Ne , Wise VA 24293-7919. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Fuller, Maranda Vandyke can be contacted via phone (276) 328-8017.

Contact Information

Primary practice address
628 Lake St Ne Wise VA 24293-7919
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X 0813000748 Virginia

Profile Details

NPI number 1487179438
LBN Legal business name Fuller, Maranda Vandyke
Credentials ED.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2017
Last updated Aug 11th, 2017 - about 8 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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