Provider Demographics
NPI:1255936704
Name:OJANAMA, SAMANTHA ANNE (MSW)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:ANNE
Last Name:OJANAMA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:ANNE
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:2130 FULS RD
Mailing Address - Street 2:
Mailing Address - City:FARMERSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45325-9285
Mailing Address - Country:US
Mailing Address - Phone:937-286-5792
Mailing Address - Fax:
Practice Address - Street 1:2130 FULS RD
Practice Address - Street 2:
Practice Address - City:FARMERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:45325-9285
Practice Address - Country:US
Practice Address - Phone:937-286-5792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS0700148104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker