Healthcare Provider Details

I. General information

NPI: 1669084026
Provider Name (Legal Business Name): HANNAH LYNN SAMAHA PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 METAIRIE RD # 8216
METAIRIE LA
70005-4034
US

IV. Provider business mailing address

609 METAIRIE RD # 8216
METAIRIE LA
70005-4034
US

V. Phone/Fax

Practice location:
  • Phone: 985-665-2794
  • Fax:
Mailing address:
  • Phone: 985-665-2794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1536
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: