Individual
MS. LYNIECE S SAMPLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, CTACC, QMHS
Contact information
Practice address
201 RIVERSIDE DR STE 2A, DAYTON, OH 45405-4956
(937) 244-3767
Mailing address
2602 COLONIAL PKWY, BEAVERCREEK, OH 45434-6288
(937) 244-3767
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/06/2026
Last updated
01/06/2026
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