Individual
ANNIKA GRACE SAMUELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
243 CHARLES ST, BOSTON, MA 02114-3096
(617) 573-3966
(617) 573-3195
Mailing address
125 S 21ST ST APT 3R, PHILADELPHIA, PA 19103-4456
(952) 836-7388
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/28/2024
Last updated
07/09/2024
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