NPI age
12 years
Enumerated 2014-01-13
● Active
Type 1 · Individual
Tina Renee Wayland Fuller, COTA/L
Wayland Fuller is 1 of 1 occupational therapy assistant providers in Mt Home and 1 of 160 in Idaho.
Primary specialty
Occupational Therapy Assistant
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2014-01-13
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 160 active occupational therapy assistant providers in Idaho.
NPI age
12 years
↑ 2 yr above median (9 yr)
State licenses
1 state
1% of peers hold multiple states
Subspecialties
0
3% of peers hold subspecialties
NPI lifetime · 2014 → 2026
2014-01Enumerated in NPPES
2014
2026
Where they practice
Practice location
895 N 6th E
Mt Home, ID 836472207
Mailing address
6397 S Mistyglen Ave
Boise, ID 837096788
Specialties
-
Occupational Therapy Assistant PrimaryAn 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...
Practice context
Solo or small practice. No other active providers share this practice address in NPPES.
Provyx · Custom healthcare lists
Need all 160 Occupational Therapy Assistant providers in Idaho?
Provyx verifies the list to your scope. Business emails and direct lines are looked up at delivery, validated, and not stored.
Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.