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General NPI Number Information
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NPI Number | 1871072777
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Entity Type | Individual
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Provider Name | SAMANTHA SIMPSON
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Gender | Female
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Dates
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Enumeration Date | 08/10/2018
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Last Update Date | 08/10/2018
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Provider Practice Location Address
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Address Line | 33330 PALMER RD
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City | WESTLAND
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State | MI
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Zip | 48186-5529
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Country | US
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Telephone | 586-633-9610
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Fax |
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Provider Business Mailing Address
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Address Line | 6834 ANNA DR
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City | VAN BUREN TWP
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State | MI
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Zip | 48111-5220
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Country | US
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Telephone | 734-660-7944
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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