Individual
SAMANTHA THAYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
320 COON RAPIDS BLVD NW STE 100, COON RAPIDS, MN 55433-5640
(952) 908-2580
Mailing address
2443 3RD AVE S APT C13, MINNEAPOLIS, MN 55404-3519
(651) 260-1299
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104958
MN
Other
Enumeration date
09/10/2015
Last updated
02/09/2016
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