Individual
SAMANTHA ROSE MANDUCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSED, LPA
Contact information
Practice address
110A EAST MAIN STREET, ROCKWELL, NC 28138
(704) 279-0626
Mailing address
110A EAST MAIN STREET, ROCKWELL, NC 28138
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5878
NC
Other
Enumeration date
05/05/2021
Last updated
05/12/2021
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