Individual
MRS. SAMANTHA MAXINE WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3200 PARKWAY RD, BIG SPRING, TX 79720-6800
(432) 263-4041
Mailing address
1300 W LOUISIANA AVE, MIDLAND, TX 79701-6046
(817) 944-1477
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
216677
TX
Other
Enumeration date
02/01/2021
Last updated
02/01/2021
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