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Individual

MISS SAMANTHA WEST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAC

Contact information

Practice address
166 MAIN ST, MATAWAN, NJ 07747-3104
(732) 290-9040
Mailing address
PO BOX 529, ISLAND HEIGHTS, NJ 08732-0529

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
37AC00447400
NJ

Other

Enumeration date
12/07/2018
Last updated
12/07/2018
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