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STACY ANN SAMUELS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSED

Contact information

Practice address
8 EVERGREEN CIR, DEKALB, IL 60115-2214
(773) 217-4907
Mailing address
5 METROPOLITAN OVAL, #3F, BRONX, NY 10462-6523
(718) 822-3873

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
174400000X
Specialist
134293071
NY

Other

Enumeration date
06/07/2012
Last updated
10/14/2022
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