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General NPI Number Information
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NPI Number | 1366224289
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Entity Type | Individual
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Provider Name | SAMONA DANTZLER LE
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Gender | Female
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Dates
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Enumeration Date | 10/16/2023
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Last Update Date | 10/16/2023
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Provider Practice Location Address
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Address Line | 11990 COIT RD STE 22
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City | FRISCO
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State | TX
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Zip | 75035-9469
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Country | US
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Telephone | 214-279-0129
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Fax |
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Provider Business Mailing Address
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Address Line | 4141 FRISCO GREEN AVE APT 248
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City | FRISCO
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State | TX
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Zip | 75034-2299
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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