Healthcare Provider Details
I. General information
NPI: 1114335437
Provider Name (Legal Business Name): ADORA SAMAAN M.A. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/30/2014
Last Update Date: 11/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8135 PAINTER AVE STE 200
WHITTIER CA
90602-3168
US
IV. Provider business mailing address
304 MOLINO AVE
LONG BEACH CA
90814-2341
US
V. Phone/Fax
- Phone: 562-698-6600
- Fax:
- Phone: 626-230-7730
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | SP20336 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: