Provider Demographics
NPI:1609386804
Name:DAGGETT, SAMANTHA (COTA)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:DAGGETT
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:
Other - Last Name:GIEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:129 WISPERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DINGMANS FERRY
Mailing Address - State:PA
Mailing Address - Zip Code:18328-3461
Mailing Address - Country:US
Mailing Address - Phone:570-878-2459
Mailing Address - Fax:
Practice Address - Street 1:1060 AMSTERDAM AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1715
Practice Address - Country:US
Practice Address - Phone:121-231-6770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-03
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant