Provider Demographics
NPI:1942984232
Name:HALAMA, SAMANTHA ELLEN (DPT)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:ELLEN
Last Name:HALAMA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:ELLEN
Other - Last Name:RICKARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1940 LAMB RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27295-5219
Mailing Address - Country:US
Mailing Address - Phone:336-300-6636
Mailing Address - Fax:
Practice Address - Street 1:1795 WESTCHESTER DR
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7008
Practice Address - Country:US
Practice Address - Phone:336-884-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP185892251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics