Provider Demographics
NPI:1770251092
Name:SOTO, EMBER SAMANTHA (OTR/L)
Entity type:Individual
Prefix:
First Name:EMBER
Middle Name:SAMANTHA
Last Name:SOTO
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 1:13924 HOMESTEAD WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78252-2367
Mailing Address - Country:US
Mailing Address - Phone:210-965-3039
Mailing Address - Fax:
Practice Address - Street 1:10839 QUARRY PARK
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78233-4681
Practice Address - Country:US
Practice Address - Phone:844-206-4512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8464-26225X00000X
TX122056225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist