Healthcare Provider Details

I. General information

NPI: 1225505142
Provider Name (Legal Business Name): SAMANTHA MARY NEEDHAM OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2018
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 COLUMBIA PIKE SUITE 125
ARLINGTON VA
22204
US

IV. Provider business mailing address

2301 COLUMBIA PIKE SUITE 125
ARLINGTON VA
22204
US

V. Phone/Fax

Practice location:
  • Phone: 202-544-5439
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number0119011239
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT210002526
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: