Individual
SAMANTHA GRACE ALLEN MAULDIN
Active
Individual
SAMANTHA GRACE ALLEN MAULDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
5742
SC
225XP0200X
Pediatric Occupational Therapist
Primary
5742
SC
225XP0200X
Pediatric Occupational Therapist
OT007076
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH4144
—
SC
Enumeration date
06/30/2018
Last updated
12/21/2022
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