Individual
SAMANTHA WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
57 DORA LN, GREENUP, KY 41144-1187
(606) 473-7333
(606) 473-7335
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
(606) 329-8588
(606) 329-8195
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
04/23/2019
Last updated
01/13/2021
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