Individual
SAMANTHIA WASH WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7108 S KANNER HWY, STUART, FL 34997-7462
(662) 721-0882
Mailing address
7134 CRAPE MYRTLE DR, OLIVE BRANCH, MS 38654-1964
(662) 721-0882
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
07/20/2026
Last updated
07/20/2026
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