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General NPI Number Information
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NPI Number | 1417411323
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Entity Type | Individual
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Provider Name | SAMANTHA JEANINE CONLEY OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/24/2019
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 18676 US HIGHWAY 17
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City | HAMPSTEAD
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State | NC
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Zip | 28443-4049
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Country | US
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Telephone | 910-821-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 2082 BURNETT BLVD
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City | WILMINGTON
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State | NC
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Zip | 28401-6940
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Country | US
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Telephone | 609-412-2413
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 15003
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License Number State | NC
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