Individual
MRS. SAMANTHA JO DOXTATOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC-IT, NCC
Contact information
Practice address
1835 E EDGEWOOD DR STE 105107, APPLETON, WI 54913-9407
(920) 234-6842
Mailing address
1835 E EDGEWOOD DR STE 105107, APPLETON, WI 54913-9407
(920) 234-6842
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8050226
WI
Other
Enumeration date
07/31/2024
Last updated
08/02/2024
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