Samantha Thomaston

NPI #1871116459 in Lagrange, Georgia

Provider Information

NPI Number: 1871116459
Entity Type: Individual
Name: Samantha Thomaston
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Professional
Enumeration Date: May 18, 2020
Last Updated: May 18, 2020

Practice Location

Address: 111 HOLLEYS GROVE DR
City: Lagrange
State: Georgia
ZIP Code: 30240-7761
Phone: (706) 812-8764

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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