Individual provider · NPI-1

Samantha Anne Mall, LLMSW

Specialist/Technologist, Other, Illustration, Medical · Southgate, MI

NPI number1396337275
StatusActive
Last updated in NPPESFeb 14, 2023

Details

NPI
1396337275
Entity type
Individual (NPI-1)
Name
Samantha Anne Mall
Credential
LLMSW
Sex
Female
Sole proprietor
No
Enumeration date
Feb 11, 2021
Certification date
Feb 8, 2023
Last updated
Feb 14, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
246ZI1000X Specialist/Technologist, Other, Illustration, Medical––Yes

Practice location

19401 Northline Rd
Southgate, MI 48195-2277

Phone 734-785-7700

Mailing address

3751 North Dixie Highway Monroe
Monore, MI 48162

Phone 574-226-5895

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