Individual
SAMANTHA LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
209 W COLLEGE ST, FARMINGTON, MO 63640-2427
(573) 701-1370
Mailing address
1 BLACK KNIGHT DR, FARMINGTON, MO 63640-2930
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
2010030858
MO
Other
Enumeration date
10/05/2016
Last updated
10/05/2016
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