Individual
SAMANTHA LEANN SPELLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
701 DEVONSHIRE DR STE B16-18, CHAMPAIGN, IL 61820-7337
(217) 531-2360
Mailing address
420 E CENTRAL AVE BLDG 420, DECATUR, IL 62521-1050
(217) 877-9117
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821055658
—
IL
Enumeration date
06/11/2018
Last updated
09/22/2020
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