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Individual
SAMANTHA CHITTENDEN
Active
Individual
SAMANTHA CHITTENDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
6801099512
MI
1041C0700X
Clinical Social Worker
Primary
6801107774
MI
1041C0700X
Clinical Social Worker
9625
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100081251
—
WI
Enumeration date
06/03/2016
Last updated
07/28/2021
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