Individual
EMILY SAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
123 WESTMARK BLVD, LAFAYETTE, LA 70506-7345
(337) 255-0950
Mailing address
123 WESTMARK BLVD, LAFAYETTE, LA 70506-7345
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
103K00000X
LA
Other
Enumeration date
12/02/2024
Last updated
12/02/2024
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