Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jennifer Lyn Fuller

Individual provider Behavior Technician · NPI 1609632421

Jennifer Lyn Fuller is a Behavior Technician in Blaine, Minnesota. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

1114 112th Ln NE
Blaine, MN 55434-4547
Phone: (612) 644-8021
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X

Record details

NPI number1609632421
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 28, 2024
Last updated in NPPESFebruary 28, 2024
Certification dateFebruary 28, 2024
Mailing address1250 Moore Lake Dr E, Fridley, MN 55432-5134

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