Provider Information for 1558926782
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SAMANTHA PRINCE MA, LPC
Sex: Female
NPI: 1558926782
Last Updated: 2024-06-11
Certification Date: 2024-06-11
Certification Date: 2024-06-11
Details
| Name | Value | ||||||||||||
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| NPI | 1558926782 | ||||||||||||
| Enumeration Date | 2019-05-02 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 955 CARMALT ST DICKSON CITY, PA 18519-1213 United States Phone: 610-203-0393 | Fax: | ||||||||||||
| Primary Practice Address | 3301 GREEN ST CLAYMONT, DE 19703-2052 United States Phone: 302-307-1300 | Fax: | ||||||||||||
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