Healthcare Provider Details

I. General information

NPI: 1932903267
Provider Name (Legal Business Name): SAMANTHA MESSINA
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2025
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1806 CAMBRONNE ST
NEW ORLEANS LA
70118-2102
US

IV. Provider business mailing address

1806 CAMBRONNE ST
NEW ORLEANS LA
70118-2102
US

V. Phone/Fax

Practice location:
  • Phone: 985-517-0480
  • Fax:
Mailing address:
  • Phone: 985-517-0480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225XE0001X
TaxonomyEnvironmental Modification Occupational Therapist
License Number336622
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: