Individual
MRS. SAMANTHA ASHLEY BERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
635 165 STREET, PROMISE PROGRAM 6TH FLOOR, NEW YORK, NY 10032
(212) 305-4360
Mailing address
635 165 STREET, PROMISE PROGRAM 6TH FLOOR, NEW YORK, NY 10032
(212) 305-4360
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/10/2013
Last updated
07/10/2013
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