Provider Demographics
NPI:1972139210
Name:KIRSHNER, SAMANTHA (OTD , OTR/L)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:KIRSHNER
Suffix:
Gender:F
Credentials:OTD , OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7401 BEAUFONT SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-5520
Mailing Address - Country:US
Mailing Address - Phone:804-272-0114
Mailing Address - Fax:
Practice Address - Street 1:7401 BEAUFONT SPRINGS DR STE 205
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23225-5504
Practice Address - Country:US
Practice Address - Phone:804-272-0114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-18
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119008964225X00000X
MA12833225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist