| NPI | 1356721039 |
|---|---|
| Former Name | SAMANTHA TILTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 10764) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2022-03-02 |