Doctor Name: | MS. SAMANTHA ANNE MIEMCZEWSKI |
NPI Number: | 1033456348 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | B.A. |
License Number: | |
Business Practice Address: | 1845 Grandstand Pl Elgin, IL - 601236603 |
Business Phone Number: | 3312221442 |
Business Fax Number: | |
Mailing Address: | 1845 Grandstand Pl, ELGIN |
State: | IL |
Postal Code: | 601236603 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/07/2013 |
NPI Last Update Date: | 01/07/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |