Individual
SAMANTHA MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
634 BULTMAN DR STE B, SUMTER, SC 29150-2597
(803) 757-1201
Mailing address
20 MESQUITE CV, SUMTER, SC 29153-8404
(803) 795-6870
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
2706
SC
3747P1801X
Personal Care Attendant
Primary
ICHP-1466
SC
Other
Enumeration date
09/22/2011
Last updated
04/29/2021
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