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1063809929
SAMANTHA MAXWELL
SAN RAFAEL, CA
NPI
1063809929
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-04-17
Last Update Date
2015-04-17
Business Address
-- SAMANTHA MAXWELL BA
1601 2ND ST
SAN RAFAEL, CA 94901-2712
Phone number: 415-456-6655
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Mailing Address
-- SAMANTHA MAXWELL BA
1601 2ND ST
SAN RAFAEL, CA 94901-2712
Phone number: 415-456-6655
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