Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Samantha Gannon, OTR

Individual provider Occupational Therapist · NPI 1417545070

Samantha Gannon, OTR is an Occupational Therapist in Madison, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2021.

Licensed in
WI
In the registry since
2021
What do these letters mean?
OTR — Occupational Therapist, Registered
A nationally registered occupational therapist.

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Practice location Address checks out

317 Knutson Dr
Madison, WI 53704-1133
Phone: (608) 301-9376
Fax: (608) 301-9388
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 6717-26 (WI)

Record details

NPI number1417545070
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTR
Sole proprietorNo
NPI enumeratedJanuary 8, 2021
Last updated in NPPESJanuary 8, 2021
Certification dateJanuary 8, 2021

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