Healthcare Provider Details

I. General information

NPI: 1770566473
Provider Name (Legal Business Name): SAMANTHA GAYLE DELLINGER PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15700 NOBLE POINT DR
ANCHORAGE AK
99516-7545
US

IV. Provider business mailing address

15700 NOBLE POINT DR
ANCHORAGE AK
99516-7545
US

V. Phone/Fax

Practice location:
  • Phone: 954-806-3319
  • Fax:
Mailing address:
  • Phone: 954-806-3319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number201880
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: