Provider Demographics
NPI:1639624109
Name:GRISHABER, SAMANTHA NICOLE (OTR/L, OTD)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:NICOLE
Last Name:GRISHABER
Suffix:
Gender:F
Credentials:OTR/L, OTD
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:NICOLE
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 306556
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6556
Mailing Address - Country:US
Mailing Address - Phone:615-329-2294
Mailing Address - Fax:615-694-1494
Practice Address - Street 1:8 CITY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-2558
Practice Address - Country:US
Practice Address - Phone:615-263-0155
Practice Address - Fax:615-263-0171
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOT5453225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0446631Medicaid