Individual
MRS. SAMANTHA BURLESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
92-1133 PANANA ST APT 1003, KAPOLEI, HI 96707-3737
(920) 342-3197
Mailing address
92-1133 PANANA ST APT 1003, KAPOLEI, HI 96707-3737
(920) 342-3197
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
HI
106S00000X
Behavior Technician
RBT-24-359224
HI
Other
Enumeration date
10/10/2024
Last updated
01/08/2025
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