Individual
SAMANTHA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
160 LEXINGTON DR, BUFFALO GROVE, IL 60089-6929
(224) 676-0202
Mailing address
3647 N NOTTINGHAM AVE, CHICAGO, IL 60634-2243
(773) 677-6726
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-64489
IL
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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