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Individual

SAMANTHA WOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
1760 SHAWANO AVE, GREEN BAY, WI 54303-3216
(920) 499-5191
Mailing address
1760 SHAWANO AVE, GREEN BAY, WI 54303-3216

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5603-27
WI

Other

Enumeration date
07/23/2019
Last updated
07/23/2019
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