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Individual
MS. SAMANTHA MARIE GROOMS
Active
Individual
MS. SAMANTHA MARIE GROOMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006419A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100163580
—
IN
Enumeration date
07/06/2009
Last updated
01/19/2012
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