| NPI | 1164077178 |
|---|---|
| Former Name | SAMANTHA KOSTERMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 10174-123) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16658-132) |
| 104100000X Social Worker (Licence: WI 131353) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 18368) | |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2026-08-19 |