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1073258547
SAMANTHA ILLANEZ
LONGWOOD, FL
NPI
1073258547
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Additional Taxonomies
1041C0700X Social Worker, Clinical
Enumeration Date
2022-04-29
Last Update Date
2023-07-11
Business Address
SAMANTHA ILLANEZ
2135 W STATE ROAD 434
LONGWOOD, FL 32779-4983
Phone number: 407-789-2673
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Mailing Address
SAMANTHA ILLANEZ
1226 NW 111TH WAY
CORAL SPRINGS, FL 33071-6452
Phone number: 954-789-6852
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