Individual
CAROLINE E SAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4215 GANNON LN, DALLAS, TX 75237-2914
(972) 283-9090
(972) 499-0367
Mailing address
508 AIRPORT EXECUTIVE BOULEVARD, NANUET, NY 10958
(845) 425-2655
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1106805
TX
Other
Enumeration date
12/19/2014
Last updated
02/07/2023
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