Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 46TA09186600 | NJ |
N | 224Z00000X | Occupational Therapy Assistant | OP009724 | PA |
NPI | 1023656360 |
---|---|
Provider Name | Samantha Eppell |
First Address | Belvidere, NJ 07823-2509 |
Second Address | Oldwick, NJ 08858-7001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2019 |
Last Update Date | 17/12/2019 |