| NPI | 1962896498 |
|---|---|
| Former Name | SAMANTHA SZELOG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 114069) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA B0000630320) |
| 1041C0700X Social Worker, Clinical (Licence: MT BBH-LCSW-LIC-63673) | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2023-11-08 |