Individual
SAMANTA BODDAPATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
380 BUTTERFLY GARDENS DR, COLUMBUS, OH 43215-7508
(614) 355-8005
(614) 355-7855
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2639
(614) 722-2000
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
P.07745
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0315121
—
OH
Enumeration date
10/06/2016
Last updated
04/10/2025
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