Individual
SAMANTHA KAYLI POULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HIS
Contact information
Practice address
2344 BUTANO DR STE C3, SACRAMENTO, CA 95825-0617
(916) 239-4445
Mailing address
2344 BUTANO DR STE C3, SACRAMENTO, CA 95825-0617
(916) 239-4445
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HA8381
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HA8381
HEARING AID DISPENSER
CA
Enumeration date
04/02/2018
Last updated
07/15/2020
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