Individual
SAMANTHA WOLFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
42804 GARFIELD RD, CLINTON TOWNSHIP, MI 48038-1656
(586) 323-2957
(586) 323-0022
Mailing address
901 WHEATFIELD DR, LAKE ORION, MI 48362-3496
(248) 672-8577
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101002237
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730363573
CRAWL, WALK, JUMP, RUN THERAPY CLINIC, LLC
MI
Enumeration date
01/10/2022
Last updated
01/10/2022
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