Laura Lyn Fuller, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP8363 Issued in AZ

Practice address

3012 N 17TH Ave
Phoenix, AZ 85015-6112

Phone

(480) 824-8889

NPI assigned

Jul 23, 2013

Last updated

Aug 13, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Amy Grulke, PLLC

  dba Arbor Therapy

  • Speech-Language Pathologist
  • Chandler, AZ
  • NPI 1316464795
  Medicare reassignment NPD
• Speech Therapy Solutions, LLC

  dba Reach Therapy Solutions

  • Speech-Language Pathologist
  • Phoenix, AZ
  • NPI 1275924219
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1255773933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3012 N 17TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850156112",
            "telephone_number": "480-824-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3012 N 17TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850156112",
            "telephone_number": "480-824-8889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2950 N Dobson Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852241819",
            "country_code": "US",
            "telephone_number": "480-208-6539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "LAURA",
        "middle_name": "LYN",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP8363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fuller Theological Seminary
• Aaron Bryce Fuller, COTA
• Bryan L Fuller, O.D.
• Carolyn M Fuller, ND
• Jennifer Fuller
• Lisa Marie Fuller, OTR/L
• Misty Marie Fullerton, D.C.
• Jonathan Daniel Fullner, M.D.
• Samaiyah Fullylove
• Shane Amour Fulton, CNA , MD

• Speech-Language Pathologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.