Individual
CAROLYN LOUISE SAMUELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1139 WASHINGTON RD, THOMSON, GA 30824
(706) 962-1449
Mailing address
1139 WASHINGTON RD, THOMSON, GA 30824-7523
(706) 962-1449
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
171M00000X
Case Manager/Care Coordinator
052938532
GA
171M00000X
Case Manager/Care Coordinator
Primary
—
LA
Other
Enumeration date
05/04/2015
Last updated
12/27/2018
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