Individual
SAMUEL KEITH VANDERBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
1109 N COOPER ST, ARLINGTON, TX 76011-5545
(817) 404-2207
Mailing address
102 TANGLEWOOD DR, MABANK, TX 75156-4148
(903) 603-4003
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
107145
TX
Other
Enumeration date
08/16/2022
Last updated
08/16/2022
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