Individual
BRISA S SAMUDIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5587 MURRAY AVE STE 205, MEMPHIS, TN 38119-0896
(310) 879-5554
Mailing address
5587 MURRAY AVE STE 205, MEMPHIS, TN 38119-0896
(310) 879-5554
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
29644
CA
Other
Enumeration date
10/08/2010
Last updated
09/24/2019
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