MEDICARE: JENNIFER SAMTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-09-5141	FL

General Provider Information

NPI Number	:	1821456625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER SAMTER

Provider Business Mailing Address
First Line	:	17841 GREEN WILLOW DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-2242
Country	:	US
Telephone Number	:	813-624-2571
Fax Number	:

Provider Business Practice Location Address
First Line	:	17841 GREEN WILLOW DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-2242
Country	:	US
Telephone Number	:	813-624-2571
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2016
Last Update Date	:	02/08/2016

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Directions to “ JENNIFER SAMTER ” Practice Location

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