| Provider / Organization | NPI | Date Certified |
|---|---|---|
| ENDALECH RENEE FULLER | 1093472383 | 2021-11-21 |
Endalech Renee Fuller is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1093472383. Registration indicates Endalech Renee Fuller is a provider of services with a specialization in Behavioral Health & Social Service Providers, Behavior Technician (Behavior Technician, Behavioral Health & Social Service Providers) (Behavior Technician, )
| Entity Type | Individual |
| Provider Name | Endalech Renee Fuller |
| Practice Office Address | 1445 NW MALL ST STE 2 ISSAQUAH, WA US |
| Practice Office Telephone | 4256518117 |
| Mailing Address | 1445 NW MALL ST STE 2 ISSAQUAH, WA 980277900 US |
| Business Telephone | 4256518117 |
| Code | Practice | License No State |
|---|---|---|
| 106S00000X PRIMARY | Behavioral Health & Social Service Providers Behavior Technician Behavior Technician Behavioral Health & Social Service Providers Behavior Technician |