Individual
MAMTA SAMPEMANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
14409 GREENVIEW DRIVE STE 102, LAUREL, MD 20708
(301) 498-8100
Mailing address
P. O. BOX 500, BROOKEVILLE, MD 20833-0500
(301) 498-8100
(301) 498-0009
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
05234
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05234
MARYLAND DEPT OF HEALTH & MENTAL HYGIENE
MD
Enumeration date
11/27/2018
Last updated
11/27/2018
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