Individual
EBONY SAMUELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18109 PRINCE PHILIP DR STE B200, OLNEY, MD 20832-1591
(301) 570-7415
Mailing address
12146 POND PINE DR, CLARKSBURG, MD 20871-4475
(352) 942-5151
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A5202
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/22/2018
Last updated
08/12/2019
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