Healthcare Provider Details

I. General information

NPI: 1184582058
Provider Name (Legal Business Name): CHRISTEL S SAMEDI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1565 N MAIN ST STE 205
FALL RIVER MA
02720-2972
US

IV. Provider business mailing address

6 WEIR ST APT 12
TAUNTON MA
02780-3942
US

V. Phone/Fax

Practice location:
  • Phone: 508-324-0328
  • Fax: 508-672-3619
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: