Samantha L Charbonneau Pa | |
101 Timberlachen Cir Ste 201 Lake Mary FL 32746-6124 | |
(407) 466-3467 | |
(407) 549-5987 |
Full Name | Samantha L Charbonneau Pa |
---|---|
Speciality | Marriage & Family Therapist |
Location | 101 Timberlachen Cir Ste 201, Lake Mary, Florida |
Authorized Official Name and Position | Samantha Lynn Charbonneau (MARRIAGE AND FAMILY THERAPIST) |
Authorized Official Contact | 4074663467 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Samantha L Charbonneau Pa 101 Timberlachen Cir Ste 201 Lake Mary FL 32746-6124 Ph: (407) 466-3467 | Samantha L Charbonneau Pa 101 Timberlachen Cir Ste 201 Lake Mary FL 32746-6124 Ph: (407) 466-3467 |
NPI Number | 1356878128 |
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Provider Enumeration Date | 05/11/2017 |
Last Update Date | 05/11/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356878128 | NPI | - | NPPES |
1982634275 | Other | FL | NPI TYPE 1 |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
106H00000X | Marriage & Family Therapist | MT2058 (Florida) | Primary |
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