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NPI Code Detail

MEDICARE: SAMANTHA CONAWAY

MEDICARE: SAMANTHA CONAWAY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2106S00000XBehavior TechnicianFL
3103K00000XBehavior Analyst1-23-66538FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699305763
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA CONAWAY
Provider Business Mailing Address
First Line : 1500 S DOUGLAS RD STE 230
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-4108
Country : US
Telephone Number : 844-854-1116
Fax Number :
Provider Business Practice Location Address
First Line : 206 S JEFFERSON AVE
Second Line :
City : COOKEVILLE
State : TN
Zip : 38501-4748
Country : US
Telephone Number : 931-283-2919
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2020
Last Update Date : 08/07/2023

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Directions to “ SAMANTHA CONAWAY ” Practice Location

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