Individual
SAMANTHA LAROSE TWADDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APC, NCC
Contact information
Practice address
1004 N 17TH ST, LANETT, AL 36863-6734
(571) 379-0336
Mailing address
1004 N 17TH ST, LANETT, AL 36863-6734
(571) 379-0336
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC009427
GA
Other
Enumeration date
01/15/2024
Last updated
01/15/2024
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