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General NPI Number Information
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NPI Number | 1114865227
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Entity Type | Individual
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Provider Name | FAITH FUCETOLA
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Gender | Female
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Dates
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Enumeration Date | 03/23/2026
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Last Update Date | 03/23/2026
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Provider Practice Location Address
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Address Line | 1127 QUEENSBOROUGH BLVD STE 104
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City | MOUNT PLEASANT
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State | SC
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Zip | 29464-5431
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Country | US
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Telephone | 843-216-0290
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Fax |
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Provider Business Mailing Address
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Address Line | 360 STONEWALL CT APT 4204
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City | MOUNT PLEASANT
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State | SC
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Zip | 29464-7990
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Country | US
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Telephone | 570-369-7408
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 7916
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License Number State | SC
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