Provider Demographics
NPI:1871159830
Name:SAMPSON, MARA (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:MARA
Middle Name:
Last Name:SAMPSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MARA
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3430 BURNET AVENUE
Mailing Address - Street 2:4007
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-2833
Mailing Address - Country:US
Mailing Address - Phone:513-636-4651
Mailing Address - Fax:
Practice Address - Street 1:3430 BURNET AVENUE
Practice Address - Street 2:4007
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-2833
Practice Address - Country:US
Practice Address - Phone:513-636-4651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-15
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics