MISS Fountalene Lashae Puckett, COTA/L

NPI #1740658186 in Hartford, Kentucky

Provider Information

NPI Number
1740658186
Entity Type
Individual
Name
MISS Fountalene Lashae Puckett, COTA/L
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Occupational Therapy Assistant
Credential
COTA/L
Enumeration Date
Sep 2, 2015
Last Updated
Sep 2, 2015

Practice Location

Address
1211 MAIN ST
ZIP Code
42347-1619
Phone
(270) 298-5426

Specialties & Taxonomy Codes

Specialty
Occupational Therapy Assistant

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