Individual
SAMANTHA DISADOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAT
Contact information
Practice address
248 HIGBIE LN FL 1, WEST ISLIP, NY 11795-2828
(631) 867-2501
Mailing address
6619 BURNS ST, REGO PARK, NY 11374-3927
(203) 616-0794
Taxonomy
Speciality
Code
Description
License number
State
101200000X
Drama Therapist
Primary
002372-01
NY
Other
Enumeration date
02/15/2018
Last updated
06/08/2025
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