Individual
SAMANTA WALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
80 GAINSBOROUGH DR, LEWES, DE 19958-9429
(914) 886-5980
Mailing address
80 GAINSBOROUGH DR, LEWES, DE 19958-9429
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09111300
NJ
Other
Enumeration date
08/11/2015
Last updated
08/11/2015
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