Individual
SAMANTHA FANTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4524 N WINDSOR DR, SPOKANE, WA 99205-2052
(509) 903-5483
Mailing address
4524 N WINDSOR DR, SPOKANE, WA 99205-2052
(509) 903-5483
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154959484
SLP
WA
01
—
SI61064749
SLP
WA
Enumeration date
03/31/2020
Last updated
07/24/2023
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