Mrs Samantha Fordham Depue, MED CCC-SLP, BCBA is a
Behavior Analyst based in Columbus, Georgia. Mrs Samantha Fordham Depue is licensed to practice in * (Not Available) (license number 1-22-62671) and her current practice location is
3623 Calvin Dr, Columbus, Georgia. She can be reached at her office (for appointments etc.) via phone at
(706) 940-5100.
NPI number for Mrs Samantha Fordham Depue is 1114041613 and her current mailing address is 3623 Calvin Dr, Columbus, Georgia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1114041613.
Healthcare Provider's Profile
| Full Name | Mrs Samantha Fordham Depue |
|---|
| Gender | Female |
|---|
| Speciality | Behavior Analyst |
|---|
| Location | 3623 Calvin Dr, Columbus, Georgia |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1114041613
- Provider Enumeration Date: 03/19/2007
- Last Update Date: 11/21/2022
Medical Identifiers
Medical identifiers for Mrs Samantha Fordham Depue such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1114041613 | NPI | - | NPPES |
| 1-22-62671 | Other | | BEHAVIOR ANALYST CERTIFICATION BOARD |
| SLP 6138 | Other | GA | GA LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 235Z00000X | Speech-language Pathologist | SLP6138 (Georgia) | Secondary |
| 103K00000X | Behavior Analyst | 1-22-62671 (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Samantha Fordham Depue is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mrs Samantha Fordham Depue, MED CCC-SLP, BCBA
3623 Calvin Dr,
Columbus, GA 31904-7915
Ph: (706) 940-5100 | Mrs Samantha Fordham Depue, MED CCC-SLP, BCBA
3623 Calvin Dr,
Columbus, GA 31904-7915
Ph: (706) 940-5100 |
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