Individual
SAMANTHA NICOLE SPEED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1640 POWERS FERRY RD SE STE 250, MARIETTA, GA 30067-5491
(704) 873-1011
(704) 832-2253
Mailing address
11307 JEFFERSON CIR N, CHAMBLEE, GA 30341-2699
(980) 622-9735
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
A12038
NC
101YM0800X
Mental Health Counselor
Primary
APC006696
GA
101YP2500X
Professional Counselor
A12038
NC
Other
Enumeration date
02/03/2016
Last updated
10/18/2018
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