Thomas, Samantha Nicole

Thomas, Samantha Nicole is an individual health care provider with primary practice located at 121 Webb Dr Ste 400 , Davenport FL 33837-3904. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Thomas, Samantha Nicole can be contacted via phone (863) 438-6806.

Contact Information

Primary practice address
121 Webb Dr Ste 400 Davenport FL 33837-3904
Phone: (863) 438-6806
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1982271649
LBN Legal business name Thomas, Samantha Nicole
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2021
Last updated May 26th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982271649 NPPES
Florida MEDICAID 019102000

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