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Individual

SAMANTHA KINNISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LLPC

Contact information

Practice address
2401 E KATELLA AVE STE 625, ANAHEIM, CA 92806-5995
(800) 577-4701
Mailing address
3321 N BUFFALO DR STE 225, LAS VEGAS, NV 89129-6678
(702) 857-8800
(702) 857-8801

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
13771
CA

Other

Enumeration date
09/18/2024
Last updated
09/18/2024
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