Healthcare Provider Details

I. General information

NPI: 1003166133
Provider Name (Legal Business Name): SAMANTHA STRICKLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2012
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3014 MAIN ST
MARLETTE MI
48453-1231
US

IV. Provider business mailing address

3014 MAIN ST
MARLETTE MI
48453-1231
US

V. Phone/Fax

Practice location:
  • Phone: 810-510-0336
  • Fax:
Mailing address:
  • Phone: 810-510-0336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6362010336
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: