Individual
MISS SAMANTHA L HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3057 CLEVELAND AVE SW, CANTON, OH 44707-3625
(330) 484-2547
Mailing address
408 COMMONWEALTH AVE NE, MASSILLON, OH 44646-4526
(330) 760-3576
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.05487
OH
Other
Enumeration date
08/26/2014
Last updated
08/26/2014
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