Healthcare Provider Details

I. General information

NPI: 1790345346
Provider Name (Legal Business Name): SAMANTHA L NEVA M.S. CCC SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAMANTHA STECKLER

II. Dates (important events)

Enumeration Date: 06/17/2019
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 1ST AVE S
JAMESTOWN ND
58401-4745
US

IV. Provider business mailing address

221 UNIVERSITY AVE STE 203
WILLISTON ND
58801-5618
US

V. Phone/Fax

Practice location:
  • Phone: 701-269-1070
  • Fax: 701-425-0606
Mailing address:
  • Phone: 701-580-8788
  • Fax: 701-609-5231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1943
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: