MEDICARE: SAMANTHA KIRSHNER OTD , 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	0119008964	VA
2	225X00000X	Occupational Therapist	12833	MA

General Provider Information

NPI Number	:	1972139210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA KIRSHNER OTD , OTR/L

Provider Business Mailing Address
First Line	:	7401 BEAUFONT SPRINGS DR
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23225-5520
Country	:	US
Telephone Number	:	804-272-0114
Fax Number	:

Provider Business Practice Location Address
First Line	:	7401 BEAUFONT SPRINGS DR STE 205
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23225-5504
Country	:	US
Telephone Number	:	804-272-0114
Fax Number	:

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

Provider Enumeration Date	:	03/18/2020
Last Update Date	:	10/25/2023

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