Provider Demographics
NPI:1124844212
Name:HELSLEY, SAMANTHA MICHELLE (OTR/L)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:MICHELLE
Last Name:HELSLEY
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 1:5005 STRAUSS CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-7776
Mailing Address - Country:US
Mailing Address - Phone:540-841-4215
Mailing Address - Fax:
Practice Address - Street 1:9852 FAIRMONT AVE
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-3176
Practice Address - Country:US
Practice Address - Phone:571-762-0751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-23
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119010725225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist