Individual
SAMANTHA WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
701 DEVONSHIRE DR STE B16-18, CHAMPAIGN, IL 61820-7337
(217) 531-2360
(217) 352-2635
Mailing address
1107 E FLORIDA AVE APT 23B, URBANA, IL 61801-6062
(217) 840-3098
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/04/2021
Last updated
12/04/2021
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