| NPI | 1023518651 |
|---|---|
| Former Name | SAMANTHA ROSE ANGELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 4016) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 11672) |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2023-10-26 |