Basic Information
| Provider Information | |||||||||
| NPI: | 1134536337 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KOGLER | ||||||||
| FirstName: | SAMANTHA | ||||||||
| MiddleName: | ERIN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | OTD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9097 E DESERT COVE AVE STE 110 | ||||||||
| Address2: | |||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852606276 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6023298250 | ||||||||
| FaxNumber: | 4805651898 | ||||||||
| Practice Location | |||||||||
| Address1: | 16968 W BELL RD # D401 | ||||||||
| Address2: | |||||||||
| City: | SURPRISE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853748943 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6232999190 | ||||||||
| FaxNumber: | 6232999191 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2014 | ||||||||
| LastUpdateDate: | 02/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | AZ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.