Individual
SAMANTHA JO SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
28 MAPLE ST #467, DOUGLAS, MA 01516
(214) 418-7902
Mailing address
28 MAPLE ST #467, DOUGLAS, MA 01516
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
14527
MA
225X00000X
Occupational Therapist
OT-2408
ID
225X00000X
Occupational Therapist
OT.0004858
CO
Other
Enumeration date
08/29/2022
Last updated
08/29/2022
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