Individual
SAMANTHA JO COYLE-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L, CPST
Contact information
Practice address
413 13TH AVE NE, MINOT, ND 58703-1570
(218) 368-6104
Mailing address
413 13TH AVE NE, MINOT, ND 58703-1570
(218) 368-6104
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1667
ND
225XP0200X
Pediatric Occupational Therapist
Primary
1667
ND
225XP0200X
Pediatric Occupational Therapist
OT-2606
HI
Other
Enumeration date
08/28/2018
Last updated
04/29/2026
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