MEDICARE: MISS SAMANTHA BRIANNA PLEASANT WASHINGTON MSOT, OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT007661	GA
2	225X00000X	Occupational Therapist	125344	TX
3	225XR0403X	Driving and Community Mobility Occupational Therapist	OT007661	GA
4	225XE0001X	Environmental Modification Occupational Therapist	OT007661	GA
5	225XE1200X	Ergonomics Occupational Therapist	OT007661	GA
6	225XL0004X	Low Vision Occupational Therapist	OT007661	GA

General Provider Information

NPI Number	:	1093154981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SAMANTHA BRIANNA PLEASANT WASHINGTON MSOT, OTR/L

Provider Business Mailing Address
First Line	:	345 PARKWOOD WAY
Second Line	:
City	:	JONESBORO
State	:	GA
Zip	:	30236-1321
Country	:	US
Telephone Number	:	470-896-4125
Fax Number	:

Provider Business Practice Location Address
First Line	:	812 MURROW CT
Second Line	:
City	:	FAIRBURN
State	:	GA
Zip	:	30213-4607
Country	:	US
Telephone Number	:	770-407-9034
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2013
Last Update Date	:	12/17/2025

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