Individual
SAMANTHA SPATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SCHOOL PSYCHOLOGIST
Contact information
Practice address
90 AIR PARK DR, RONKONKOMA, NY 11779-7360
(631) 580-4000
Mailing address
30 PENN CMNS, YAPHANK, NY 11980-2026
(631) 455-2646
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
2620416
NY
103TS0200X
School Psychologist
Primary
2620464
NY
Other
Enumeration date
06/13/2018
Last updated
03/22/2021
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