Provider Demographics
NPI:1700597408
Name:SEWARD, SAMANTHA DENISE (OTR/L)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:DENISE
Last Name:SEWARD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 JACKSON ST NE APT 109
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-4009
Mailing Address - Country:US
Mailing Address - Phone:859-640-7197
Mailing Address - Fax:
Practice Address - Street 1:2211 TOWN CENTER DR SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-4001
Practice Address - Country:US
Practice Address - Phone:202-390-1549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT210002054225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist