TINA WAYLAND FULLER, COTA/L
Occupational Therapy Assistant
Active
Individual
NPI: 1922420736
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | Yes | OTA-1095 (ID) |
Frequently Asked Questions
NPI 1922420736 is the National Provider Identifier for TINA WAYLAND FULLER, COTA/L, a Occupational Therapy Assistant provider located in Mt Home, ID. This NPI was enumerated on January 13, 2014.
TINA WAYLAND FULLER, COTA/L practices at 895 N 6TH E, Mt Home, ID 83647.
Quick Facts
- NPI
- 1922420736
- Type
- Individual
- Enumerated
- Jan 13, 2014
- Last Updated
- Jan 13, 2014
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