Provider Demographics
NPI:1558968123
Name:OATES, SAMANTHA (OTD)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:OATES
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4328 CENTRAL AVE STE M
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-5907
Mailing Address - Country:US
Mailing Address - Phone:501-701-4348
Mailing Address - Fax:
Practice Address - Street 1:4328 CENTRAL AVE STE M
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-5907
Practice Address - Country:US
Practice Address - Phone:501-701-4348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR3415225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist