Individual
MRS. SAMANTHA D'ESTI EISENHART-PETKOVSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, LPC
Contact information
Practice address
60657 S LYON TRL, SOUTH LYON, MI 48178-9054
(321) 356-0146
Mailing address
204 EAGLE CT, BEDFORD, TX 76021-3216
(972) 895-2326
(866) 627-3513
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH8108
FL
101YP2500X
Professional Counselor
6401011614
MI
101YP2500X
Professional Counselor
Primary
77807
TX
Other
Enumeration date
04/17/2007
Last updated
02/18/2025
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