Individual
GIANNA MARIE JACULLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1110 HEATHER GLEN BLVD, LITTLE RIVER, SC 29566-5947
(631) 708-7913
Mailing address
1110 HEATHER GLEN BLVD, LITTLE RIVER, SC 29566-5947
(631) 708-7913
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7159
SC
Other
Enumeration date
04/20/2024
Last updated
11/18/2025
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