Individual
ROESHELLE SMITH-SAMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
31 PROFESSIONAL VILLAGE CIR, LADYS ISLAND, SC 29907-1575
(843) 371-1602
(803) 905-4431
Mailing address
181 W PROFESSIONAL PARK CT STE 1, BOWLING GREEN, KY 42104-3250
(270) 777-9283
(270) 777-9283
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-37766
SC
Other
Enumeration date
08/10/2017
Last updated
08/10/2017
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