Individual
MARY HELEN FUQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
809 LAMONT ST, JOHNSON CITY, TN 37604-5453
(423) 926-1171
Mailing address
PO BOX 4000, MOUNTAIN HOME, TN 37684-4000
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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