Walsh, Samantha Christine

Walsh, Samantha Christine is an individual health care provider with primary practice located at 420 Pennsylvania Ave Ste 101 , Glen Ellyn IL 60137-4427. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Art Therapist, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Walsh, Samantha Christine can be contacted via phone (630) 474-4353.

Contact Information

Primary practice address
420 Pennsylvania Ave Ste 101 Glen Ellyn IL 60137-4427
Phone: (630) 474-4353
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Art Therapist 221700000X
Behavioral Health & Social Service Providers / Counselor 101Y00000X

Profile Details

NPI number 1013559772
LBN Legal business name Walsh, Samantha Christine
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 15th, 2019
Last updated Oct 15th, 2019 - about 5 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 1013559772 NPPES
Illinois Other 178015101 IDFPR LISENCE NUMBER

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