Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gianna Marie Jacullo, OTR/L

Individual provider Occupational Therapist · NPI 1841045119

Gianna Marie Jacullo, OTR/L is an Occupational Therapist in Private Practice in Little River, South Carolina. Qualified in 2024, 2 years ago. Practices with Legacy Healthcare Services Inc, a 3,624-clinician group and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
2
Licensed in
SC
In the registry since
2024
What do these letters mean?
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

1110 Heather Glen Blvd
Little River, SC 29566-5947
Phone: (631) 708-7913
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 7159 (SC)

Record details

NPI number1841045119
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTR/L
Sole proprietorYes
NPI enumeratedApril 20, 2024
Last updated in NPPESNovember 18, 2025
Certification dateNovember 18, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Legacy Healthcare Services Inc — 3624 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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