Provider Demographics
NPI:1245920230
Name:HENDRIX, SAMARAH HAYS
Entity type:Individual
Prefix:
First Name:SAMARAH
Middle Name:HAYS
Last Name:HENDRIX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2754 GOODFELLOWS RD
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-2704
Mailing Address - Country:US
Mailing Address - Phone:770-310-3340
Mailing Address - Fax:
Practice Address - Street 1:2754 GOODFELLOWS RD
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-2704
Practice Address - Country:US
Practice Address - Phone:770-310-3340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist