Individual
MRS. ERICKA SAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
259 E OAKDALE AVE, CRESTVIEW, FL 32539-3547
(850) 682-1234
(850) 689-8799
Mailing address
259 E OAKDALE AVE, CRESTVIEW, FL 32539-3547
(850) 682-1234
(850) 689-8799
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW 10591
FL
Other
Enumeration date
11/22/2011
Last updated
11/22/2011
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