Individual
SAMANTHA LONGMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3435 W CRAIG RD STE B, N LAS VEGAS, NV 89032-5116
Mailing address
5370 E CRAIG RD, LAS VEGAS, NV 89115-2100
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82-1787155
—
NV
Enumeration date
05/26/2020
Last updated
05/26/2020
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