Individual
CARLY SAMACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 LINCOLN AVE, GLENS FALLS, NY 12801-2610
(518) 788-8044
Mailing address
1 LINCOLN AVE, GLENS FALLS, NY 12801-2610
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
010866
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
394750717
DRIVERS LICENSE
NY
Enumeration date
03/08/2021
Last updated
03/08/2021
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