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:
Health care specialties
Specialty | Code | License # | 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 6 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1013559772 | NPPES |
Illinois | Other | 178015101 | IDFPR LISENCE NUMBER |
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