Individual
JENNIE SAMUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
9300 DEWITT LOOP, FORT BELVOIR COMMUNITY HOSPITAL, FORT BELVOIR, VA 22060
(571) 231-1211
Mailing address
9300 DEWITT LOOP, FORT BELVOIR COMMUNITY HOSPITAL, FORT BELVOIR, VA 22060
(571) 231-1211
Taxonomy
Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
Primary
06487
MD
225XN1300X
Neurorehabilitation Occupational Therapist
06487
MD
Other
Enumeration date
04/26/2010
Last updated
05/01/2015
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