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Samantha Walter

Behavior Technician in Melville, NY. Individual provider (NPI-1).

NPI number1679110886
StatusActive
Last updated in NPPESDec 6, 2019

Details

NPI
1679110886
Entity type
Individual (NPI-1)
Name
Samantha Walter
Sex
Female
Sole proprietor
No
Enumeration date
Dec 6, 2019
Last updated
Dec 6, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior Technician–NYYes

Practice location

225 Broadhollow Rd Ste 402
Melville, NY 11747-4899

Phone 631-385-7780

Mailing address

7000 Austin St
Forest Hills, NY 11375-1022

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