Provider Demographics
NPI:1285159020
Name:D'ALANNO, SAMANTHA (COTA)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:
Last Name:D'ALANNO
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 E KIRWIN AVE
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-6329
Mailing Address - Country:US
Mailing Address - Phone:785-627-6080
Mailing Address - Fax:
Practice Address - Street 1:202 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:KS
Practice Address - Zip Code:67464-9775
Practice Address - Country:US
Practice Address - Phone:785-546-2211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-12
Last Update Date:2017-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-04842224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant