Individual
SAMANTHA GRACE SIEBOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26 MAIN ST, EDISON, NJ 08837-3418
(609) 521-4746
Mailing address
1039 JERSEY AVE, GLOUCESTER CITY, NJ 08030-2421
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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