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General NPI Number Information
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NPI Number | 1841855434
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Entity Type | Individual
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Provider Name | SAMANTHA NICOLE RUDMAN LCPC
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Gender | Female
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Dates
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Enumeration Date | 05/08/2019
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 6508 DEER POINTE DR STE 4
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City | SALISBURY
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State | MD
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Zip | 21804-1668
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Country | US
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Telephone | 410-742-6016
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Fax | 410-742-6014
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Provider Business Mailing Address
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Address Line | 6508 DEER POINTE DR STE 4C
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City | SALISBURY
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State | MD
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Zip | 21804-1668
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Country | US
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Telephone | 410-742-6016
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Fax | 410-742-6014
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | MD
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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 | LC15999
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License Number State | MD
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