Fuller, Mia

Fuller, Mia is an individual health care provider with primary practice located at 11180 State Bridge Rd Suite 305, Alpharetta GA 30022-7482. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist is her primary health care specialty. Fuller, Mia can be contacted via phone (678) 992-0303.

Contact Information

Primary practice address
11180 State Bridge Rd Suite 305 Alpharetta GA 30022-7482
Phone: (678) 992-0303
Fax: (678) 992-0302
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand 225XH1200X OT000932 Georgia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X OT000932 Georgia

Profile Details

NPI number 1619045770
LBN Legal business name Fuller, Mia
Credentials MS,OTR,CHT
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2006
Last updated Aug 16th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1619045770 NPPES
Georgia MEDICAID 501099970B

Popular Providers