Provider Demographics
NPI:1043052368
Name:LERNER, SAMANTHA ALISON (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:ALISON
Last Name:LERNER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:ALISON
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4736 ATRIUM CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-0202
Mailing Address - Country:US
Mailing Address - Phone:336-404-8005
Mailing Address - Fax:
Practice Address - Street 1:5919 OLEANDER DR STE 119
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4757
Practice Address - Country:US
Practice Address - Phone:910-395-2995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16379225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist