Provider Demographics
NPI:1417411323
Name:CONLEY, SAMANTHA JEANINE (OTR/L)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:JEANINE
Last Name:CONLEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2428 W THOMPSON ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19121-4848
Mailing Address - Country:US
Mailing Address - Phone:609-412-2413
Mailing Address - Fax:
Practice Address - Street 1:4 NESHAMINY INTERPLEX STE 202
Practice Address - Street 2:
Practice Address - City:TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6944
Practice Address - Country:US
Practice Address - Phone:267-460-0045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics