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Individual

MRS. ANDREA NICOLE SAMUEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
4141 B ST STE 302, ANCHORAGE, AK 99503-5942
(907) 887-6181
Mailing address
4141 B ST STE 302, ANCHORAGE, AK 99503-5942
(907) 887-6181
(907) 646-1400

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
116
AK
235Z00000X
Speech-Language Pathologist
Primary
SLPS116
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1031235
AK
Enumeration date
06/23/2010
Last updated
02/04/2020
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