Individual
SAMANTHA LAYNE REGISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
64 LILLIAN SPRINGS RD, QUINCY, FL 32351-2015
(850) 491-7482
Mailing address
64 LILLIAN SPRINGS RD, QUINCY, FL 32351-2015
(850) 491-7482
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA18657
FL
Other
Enumeration date
12/17/2021
Last updated
12/17/2021
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