TINA RENEE WAYLAND FULLER COTA/L
NPI 1922420736
Occupational Therapy Assistant in Mt Home, ID

Active since January 13, 2014
895 N 6TH E, MT HOME, ID 83647(208) 580-9806 Get Directions Write a Review

NPPES record last updated: January 13, 2014. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Tina Renee Wayland Fuller Cota/l NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TINA RENEE WAYLAND FULLER COTA/L (NPI 1922420736) is an individual occupational therapy assistant in Mt Home, Idaho, licensed in Idaho (OTA-1095) and active in the NPI registry since January 2014.

NPPES Registry Identity

NPI1922420736
Entity TypeIndividualFemale
Primary Taxonomy224Z00000X
Provider Legal NameTINA RENEE WAYLAND FULLERCredential: COTA/L
Location Address895 N 6TH EMt Home, ID 83647-2207
Mailing Address6397 S Mistyglen AveBoise, ID 83709-6788 · (208) 914-3167
Sole ProprietorNo
Enumeration DateJanuary 13, 2014
NPI 1922420736 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOccupational Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code224Z00000X
License Licensed in ID · OTA-1095
Definition
An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examination for occupational therapy assistants, and fulfills state requirements for licensure, certification, or registration. An occupational therapy assistant provides interventions under the supervision of an occupational therapist which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapy assistants address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
895 N 6TH E, Mt Home, ID 83647

Other Names 1

Former Name (1)Tina Renee Smith Cota/l

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

General Acute Care Hospital (Critical Access)
895 N 6TH E
MOUNTAIN HOME, ID 83647
Occupational Therapist (Physical Rehabilitation)
895 N 6TH E
MOUNTAIN HOME, ID 83647
Skilled Nursing Facility
895 N 6TH E
MOUNTAIN HOME, ID 83647
Pharmacist
895 N 6TH E
MOUNTAIN HOME, ID 83647
Pharmacy (Long Term Care Pharmacy)
895 N 6TH E
MTN HOME, ID 83647
Nursing Facility/Intermediate Care Facility
895 N 6TH E
MTN HOME, ID 83647
Emergency Medicine
895 N 6TH E
MOUNTAIN HOME, ID 83647
Specialist
895 N 6TH E
MOUNTAIN HOME, ID 83647

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tina Wayland Fuller's NPI number?

The NPI number for Tina Wayland Fuller is 1922420736. It was assigned to this individual provider in the NPPES registry on January 13, 2014. The provider is also known as Tina Renee Smith Cota/L.

Where is Tina Wayland Fuller located?

Tina Wayland Fuller practices at 895 N 6th E, Mt Home, ID 83647. The listed phone number is (208) 580-9806.

What is Tina Wayland Fuller's specialty?

The primary specialty registered for this NPI is Occupational Therapy Assistant with taxonomy code 224Z00000X.

When was this NPI record last updated?

The NPPES record for Tina Wayland Fuller was last updated on January 13, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.