Provider Demographics
NPI:1538761481
Name:MARTEL, SAMANTHA (OTS)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:MARTEL
Suffix:
Gender:F
Credentials:OTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 BALTIMORE ANNAPOLIS BLVD
Mailing Address - Street 2:STE 111
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-3956
Mailing Address - Country:US
Mailing Address - Phone:410-544-2500
Mailing Address - Fax:
Practice Address - Street 1:9501 OLD ANNAPOLIS RD STE 125
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-6355
Practice Address - Country:US
Practice Address - Phone:443-545-7986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-14
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09472225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist