Individual
SAMANTHA BARTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
134 E COLLINS RD, FORT WAYNE, IN 46825-5302
(260) 241-6879
Mailing address
134 E COLLINS RD, FORT WAYNE, IN 46825-5302
(260) 241-6879
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
31005848A
IN
225XP0200X
Pediatric Occupational Therapist
Primary
31005848A
IN
Other
Enumeration date
03/12/2015
Last updated
08/22/2019
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