Individual
SAMANTHA LYNN COLBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
112 12TH AVE RD, NAMPA, ID 83686-5011
(084) 655-4332
(208) 466-5802
Mailing address
210 TACOMA ST, GRANTS PASS, OR 97526-9370
(541) 479-6329
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
104100000X
Social Worker
Primary
LMSW-40963
ID
Other
Enumeration date
04/10/2012
Last updated
09/20/2021
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