Provider Demographics
NPI:1407417074
Name:SCHEEL, SAMANTHA (OT)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:SCHEEL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 LAGUNA ST
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902-2330
Mailing Address - Country:US
Mailing Address - Phone:765-454-5340
Mailing Address - Fax:765-454-5347
Practice Address - Street 1:1220 LAGUNA ST
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-2330
Practice Address - Country:US
Practice Address - Phone:765-454-5340
Practice Address - Fax:765-454-5347
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31006900A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist