Individual
SAMANTHA R MCCOURT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ED.
Contact information
Practice address
43 CONESTOGA TRAIL, SPARTA, NJ 07871
(914) 443-0138
Mailing address
PO BOX 1672, 107C NORTH SHORE POINT, MONTAGUE, NJ 07827
(845) 820-1731
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
665953766
NY
Other
Enumeration date
09/28/2017
Last updated
09/28/2017
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