Individual
MISS SAMANTHA LENORE HILBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1525 MERRILL DRIVE SUITE 100, LITTLE ROCK, AR 72211
(501) 228-0063
Mailing address
500 POPLAR STREET, HEBER SPRINGS, AR 72543
(870) 668-6759
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
940570676
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8494160201
—
AR
Enumeration date
05/14/2020
Last updated
05/14/2020
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