Individual
SAMANTHA LYNN BURDETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1831 WILLIS BRANCH RD, VICTOR, WV 25938-7755
(304) 541-7041
Mailing address
1831 WILLIS BRANCH RD, VICTOR, WV 25938-7755
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C2432
WV
Other
Enumeration date
04/29/2026
Last updated
04/29/2026
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