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Individual

MARY D FULLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
727 OAKLAND ST, HENDERSONVILLE, NC 28791-3647
(828) 693-4223
Mailing address
680 FAIRVIEW FOREST DR, FAIRVIEW, NC 28730-9647
(828) 772-9631

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
13714
NC

Other

Enumeration date
04/17/2023
Last updated
12/16/2025
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