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NPI Code Detail

MEDICARE: DR. SAMANTHA JO OSCAR PH.D.

MEDICARE:  DR. SAMANTHA JO OSCAR  PH.D.
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
1103TC1900XCounseling Psychologist3145-57WI

General Provider Information

NPI Number : 1982193546
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAMANTHA JO OSCAR PH.D.
Provider Business Mailing Address
First Line : 302 N VAN BUREN ST
Second Line :
City : GREEN BAY
State : WI
Zip : 54301-4829
Country : US
Telephone Number : 408-813-0977
Fax Number :
Provider Business Practice Location Address
First Line : 107 S MADISON ST
Second Line :
City : GREEN BAY
State : WI
Zip : 54301-4501
Country : US
Telephone Number : 408-813-0977
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2018
Last Update Date : 12/09/2024

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Directions to “ DR. SAMANTHA JO OSCAR PH.D.” Practice Location

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