Individual
SAMANTHA N BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
650 N SHORELINE DR, WASILLA, AK 99654-6677
(907) 376-6363
(907) 376-6366
Mailing address
650 N SHORELINE DR, WASILLA, AK 99654-6677
(907) 376-6363
(907) 376-6366
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
134630
KY
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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