Provider Demographics
NPI:1750332185
Name:SAMS, MONA JOAN (OTR)
Entity Type:Individual
Prefix:MS
First Name:MONA
Middle Name:JOAN
Last Name:SAMS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:MONA
Other - Middle Name:JOAN
Other - Last Name:SAMMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:240 OLD MINE RD
Mailing Address - Street 2:
Mailing Address - City:TROUTVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24175-6628
Mailing Address - Country:US
Mailing Address - Phone:540-966-4941
Mailing Address - Fax:
Practice Address - Street 1:240 OLD MINE RD
Practice Address - Street 2:
Practice Address - City:TROUTVILLE
Practice Address - State:VA
Practice Address - Zip Code:24175-6628
Practice Address - Country:US
Practice Address - Phone:540-966-4941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist