Healthcare Provider Details

I. General information

NPI: 1699607143
Provider Name (Legal Business Name): SAMANTHA JEAN SKUJINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4760 BELPAR ST NW
CANTON OH
44718-3603
US

IV. Provider business mailing address

2641 REDBERRY ST
LOUISVILLE OH
44641-9814
US

V. Phone/Fax

Practice location:
  • Phone: 330-492-9200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOT013250
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: