Individual
SAMANTHA BRUSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
9887 4TH ST N STE 319, SAINT PETERSBURG, FL 33702-8445
(727) 379-2807
Mailing address
9887 4TH ST N STE 319, SAINT PETERSBURG, FL 33702-8445
(727) 379-2807
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
FL
103TC0700X
Clinical Psychologist
Primary
PY10363
FL
Other
Enumeration date
12/04/2019
Last updated
04/28/2020
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