| NPI | 1720791684 |
|---|---|
| Former Name | SAMANTHA LYNN HUMPHREY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 14033) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CT 5131) |
| Enumeration Date | 2023-01-05 |
| Last Update Date | 2024-08-12 |