Individual
NICOLE SAMUELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 PINE AVE, LONG BEACH, CA 90813-3124
(562) 595-1159
Mailing address
18 HERON, IRVINE, CA 92604-3607
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
225C00000X
Rehabilitation Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/21/2018
Last updated
08/23/2021
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