Healthcare Provider Details

I. General information

NPI: 1740940600
Provider Name (Legal Business Name): SAMANTHA VALDEZ ESPINOSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2021
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 POND ST
NORWELL MA
02061-1627
US

IV. Provider business mailing address

45 POND ST
NORWELL MA
02061-1627
US

V. Phone/Fax

Practice location:
  • Phone: 781-421-6182
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2437
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: