Individual
SAMANTHA DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1411 PRINCESS ANNE STREET, FREDERICKSBURG, VA 22401
(540) 922-1110
Mailing address
1865 ALAMANDINE AVE, AUBREY, TX 76227-5605
(847) 421-0027
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/07/2018
Last updated
05/01/2023
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