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General NPI Number Information
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NPI Number | 1407711815
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Entity Type | Individual
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Provider Name | SAMANTHA AGUILAR CPRSS
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Gender | Female
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Dates
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Enumeration Date | 12/18/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 111 W 35TH CT
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City | GRIFFITH
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State | IN
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Zip | 46319-1032
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Country | US
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Telephone | 219-316-0099
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Fax |
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Provider Business Mailing Address
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Address Line | 7137 VAN BUREN AVE
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City | HAMMOND
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State | IN
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Zip | 46324-1947
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Country | US
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Telephone | 219-501-9755
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State | IN
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