MRS. Samantha Ashley Berg

NPI #1467893115 in New York, New York

Provider Information

NPI Number: 1467893115
Entity Type: Individual
Name: MRS. Samantha Ashley Berg
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Clinic/Center - Adolescent and Children Mental Health
Enumeration Date: Jul 10, 2013
Last Updated: Jul 10, 2013

Practice Location

Address: 635 165 STREET
Address 2: PROMISE PROGRAM 6TH FLOOR
City: New York
State: New York
ZIP Code: 10032
Phone: (212) 305-4360

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health	261QM0855X	Primary

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