Provider Demographics
NPI:1831601947
Name:MUELLER, SAMANTHA RAE (OTA,COTA)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:RAE
Last Name:MUELLER
Suffix:
Gender:F
Credentials:OTA,COTA
Other - Prefix:MISS
Other - First Name:SAMANTHA
Other - Middle Name:RAE
Other - Last Name:SCIPLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTA,COTA
Mailing Address - Street 1:5721 MEADOWGLEN DR
Mailing Address - Street 2:
Mailing Address - City:ARGYLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-2256
Mailing Address - Country:US
Mailing Address - Phone:469-271-0311
Mailing Address - Fax:
Practice Address - Street 1:5721 MEADOWGLEN DR
Practice Address - Street 2:
Practice Address - City:ARGYLE
Practice Address - State:TX
Practice Address - Zip Code:76226-2256
Practice Address - Country:US
Practice Address - Phone:469-271-0311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-30
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX214603224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant