Individual provider · NPI-1

Samantha Adcock, COTA/L

Occupational Therapy Assistant · Saint Louis, MO

NPI number1396508032
StatusActive
Last updated in NPPESFeb 5, 2024

Details

NPI
1396508032
Entity type
Individual (NPI-1)
Name
Samantha Adcock
Credential
COTA/L
Sex
Female
Sole proprietor
No
Enumeration date
Feb 5, 2024
Certification date
Feb 5, 2024
Last updated
Feb 5, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
224Z00000X Occupational Therapy Assistant2012031932MOYes

Practice location

6022 S Lindbergh Blvd Ste 100
Saint Louis, MO 63123-7019

Phone 314-845-7751

Mailing address

2901 Minnesota Ave
Saint Louis, MO 63118-1323

Phone 314-403-4325

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