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Individual
SAMSON TEKLEMARIAM
Active
Individual
SAMSON TEKLEMARIAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
5606
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3000641104
WORKER'S COMP
SC
05
—
322842
—
SC
Enumeration date
08/12/2009
Last updated
05/20/2024
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