Individual provider · Type 1 NPI

Tina Renee Wayland Fuller, COTA/L

Occupational Therapy Assistant · Mount Home, ID

NPI number 1922420736 Active

Practice location

895 N 6th E
Mount Home, ID 83647-2207

Call (208) 580-9806 Map

Mailing address

6397 S Mistyglen Ave
Boise, ID 83709-6788

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapy Assistant Primary 224Z00000XOTA-1095 (ID)

Occupational Therapy Assistant: An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examinatio…

28 other providers at this address

About NPI 1922420736

Tina Renee Wayland Fuller, COTA/L's National Provider Identifier is 1922420736, issued on Jan 13, 2014. The primary taxonomy on file is Occupational Therapy Assistant (224Z00000X), and the practice location is in Mount Home, ID. The record was last updated on Jan 13, 2014.