| NPI | 1902679905 |
|---|---|
| Former Name | SAMANTHA ANN MARGARET DICKEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2023-11-01 |
| Last Update Date | 2023-11-01 |