Samantha Anderson

NPI #1134625957 in Portage, Michigan

Provider Information

NPI Number: 1134625957
Entity Type: Individual
Name: Samantha Anderson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Apr 2, 2018
Last Updated: Apr 2, 2018

Practice Location

Address: 1617 E MILHAM AVE STE B
City: Portage
State: Michigan
ZIP Code: 49002-3049
Phone: (269) 389-9102

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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