Individual
MS. SAMANTHA GRACE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 OHIO ST, MEDINA, NY 14103-1063
(585) 798-2000
Mailing address
3213 LOWER MOUNTAIN RD, SANBORN, NY 14132-9427
(716) 377-0053
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
450594
NY
Other
Enumeration date
09/16/2021
Last updated
09/16/2021
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