Individual
COURTNEY FULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
59 BEECHWOOD LN, LARGO, FL 33770-1803
(774) 242-4761
Mailing address
149 HOPE AVE, WORCESTER, MA 01603-2214
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT19607
FL
Other
Enumeration date
06/17/2019
Last updated
06/17/2019
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