Chrystal Tarryn Fullen, PsyD
Clinical Neuropsychologist in Little Rock, AR. Individual provider (NPI-1).
NPI number1053768911
StatusActive
Last updated in NPPESAug 27, 2021
Details
- NPI
- 1053768911
- Entity type
- Individual (NPI-1)
- Name
- Chrystal Tarryn Fullen
- Credential
- PsyD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 20, 2016
- Certification date
- Aug 27, 2021
- Last updated
- Aug 27, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 19-32AP-PL | AR | Yes |
Practice location
4301 W Markham St # 589Little Rock, AR 72205-7101
Phone 501-526-8284
Mailing address
4301 W Markham St # 589Little Rock, AR 72205-7101
Phone 501-526-8284
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