Individual
SAMANTHA LOU RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
531 GIDDINGS AVE, SHEBOYGAN FALLS, WI 53085-1707
(920) 550-5254
(920) 467-2199
Mailing address
464 WESTWOOD DR, SHEBOYGAN FALLS, WI 53085-1031
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4635-027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41076700
—
WI
Enumeration date
10/29/2008
Last updated
09/18/2013
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