Provider Demographics
NPI:1407348824
Name:GARCIA, SAMANTA RIMOLDI (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:SAMANTA
Middle Name:RIMOLDI
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 S CYPRESS CIR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-3153
Mailing Address - Country:US
Mailing Address - Phone:786-712-1025
Mailing Address - Fax:
Practice Address - Street 1:2720 S CYPRESS CIR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-3153
Practice Address - Country:US
Practice Address - Phone:305-216-5411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117428225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty