Provider Demographics
NPI:1700084845
Name:GUICHET, SAMANTHA SMITH (PT)
Entity Type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:SMITH
Last Name:GUICHET
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 CONSTANTINOPLE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3844
Mailing Address - Country:US
Mailing Address - Phone:504-269-9762
Mailing Address - Fax:504-895-1437
Practice Address - Street 1:1221 CONSTANTINOPLE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3844
Practice Address - Country:US
Practice Address - Phone:504-269-9762
Practice Address - Fax:504-895-1437
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA04862225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist