TINA WAYLAND FULLER

COTA/L specializing in occupational therapy assistant in Boise, Idaho

NPI: 1922420736

Provider Type

1

Practice Locations

Mailing Location

6397 S MISTYGLEN AVE

BOISE, ID 83709

📞 2089143167

Practice Location

895 N 6TH E

MT HOME, ID 83647

📞 2085809806

Provider Information

Gender:F
Sole Proprietor:No
Enumeration Date:1/13/2014
Last Updated:1/13/2014

Credentials

Primary Credential:COTA/L
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