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General NPI Number Information
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NPI Number | 1033093810
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Entity Type | Organization
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Legal Business Name | SAMANTHA B GOLD INC
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 4675 N SHALLOWFORD RD
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City | DUNWOODY
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State | GA
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Zip | 30338-6309
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Country | US
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Telephone | 678-555-3735
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Fax |
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Provider Business Mailing Address
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Address Line | 4675 N SHALLOWFORD RD
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City | DUNWOODY
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State | GA
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Zip | 30338-6309
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Country | US
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Telephone | 678-555-3735
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Fax |
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | SAMANTHA GOLD
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Credential |
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Telephone | 678-555-3735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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