Samantha Berger, COTA
Individual provider Active NPI Occupational Therapy Assistant · De Pere, WI
NPI 1730744707 · NPPES record last updated May 6, 2019
Key facts
- NPI
- 1730744707
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 5331 (WI)
- Practice address
- 1142 Orlando Dr
De Pere, WI 54115-9484 - Phone
- (920) 339-0700
- NPI assigned
- May 6, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5331 | WI | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 5331 | WI | Yes |
Addresses
Primary practice location
1142 Orlando Dr
De Pere, WI 54115-9484
Mailing address
1142 Orlando Dr
De Pere, WI 54115-9484
Phone (920) 339-0700
Other providers in De Pere, WI
- Bellin Psychiatric Center Inc
- Bellin Psychiatric Center Inc
- Lauren Madison Bellin
- Theresa Marie Benedyk
- Megan E Berendes
- Jennifer Cara Berndt
- David Eugene Bertler
- Cynthia Jane Bieda
- Amy M Biehl
- Bozena J Biernat
All providers in De Pere, WI · Occupational Therapy Assistant in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.