Individual
SAMANTHA GOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S, LCDC, LPC-I
Contact information
Practice address
219 W EUBANK ST, MABANK, TX 75147-8318
(903) 910-9540
Mailing address
219 W EUBANK ST, MABANK, TX 75147-8318
(903) 910-9540
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13440
TX
Other
Enumeration date
10/07/2019
Last updated
10/07/2019
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