Individual
MRS. WILLOW SAMSEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1230 BAXTER ST, ATHENS, GA 30606-3712
(706) 389-2950
Mailing address
1230 BAXTER ST, ATHENS, GA 30606-3712
(706) 389-2950
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
OT002550
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003133503A
—
GA
Enumeration date
09/23/2013
Last updated
08/04/2016
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