Individual
SAMANTHA THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1257 WESTOVER TRCE NW, ACWORTH, GA 30102-3468
(229) 894-8717
Mailing address
1257 WESTOVER TRCE NW, ACWORTH, GA 30102-3468
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA001635
GA
Other
Enumeration date
10/29/2014
Last updated
10/29/2014
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