Individual
SAMANTHA DIEDRE ADRASSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT-21-168594
Contact information
Practice address
27844 MANOR OAK DR, WESLEY CHAPEL, FL 33544-5367
(754) 422-4791
Mailing address
27844 MANOR OAK DR, WESLEY CHAPEL, FL 33544-5367
(754) 422-4791
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-21-168594
FL
222Q00000X
Developmental Therapist
—
FL
2355S0801X
Speech-Language Assistant
Primary
SI5594
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110674100
—
FL
Enumeration date
03/16/2022
Last updated
07/25/2023
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