Individual
STEPHANIE SAMPLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
394 PARK AVE APT A17, ORANGE, NJ 07050-2836
(201) 306-8810
Mailing address
394 PARK AVE APT A17, ORANGE, NJ 07050-2836
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL06926700
—
Other
Enumeration date
01/07/2025
Last updated
01/07/2025
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