Individual
MISS SAMANTHA T CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
817 CRAWFORD AVE, AUGUSTA, GA 30904-3772
(706) 736-1255
Mailing address
2226 LEE ST, AUGUSTA, GA 30904-4834
(347) 452-0225
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT007818
GA
Other
Enumeration date
08/11/2020
Last updated
08/11/2020
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