Individual
SAMANTHA MARIA BASTIANELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2520 PACKARD RD STE 4, YPSILANTI, MI 48197-2245
(734) 480-8099
(734) 999-3779
Mailing address
2520 PACKARD RD STE 4, YPSILANTI, MI 48197-2245
(734) 480-8099
(734) 999-3779
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
6401018726
MI
101YP2500X
Professional Counselor
Primary
6401223067
MI
Other
Enumeration date
10/20/2020
Last updated
10/03/2023
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