| NPI | 1750034856 |
|---|---|
| Former Name | SAMANTHA CARLSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OR 449404) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: OR 449404) |
| Enumeration Date | 2022-01-28 |
| Last Update Date | 2022-01-28 |