| Doctor Name: | SAMANTHA SHOOK |
| NPI Number: | 1225496870 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | P00734 |
| Business Practice Address: | 2155 State Route 22b Morrisonville, NY - 129623417 |
| Business Phone Number: | 5185638000 |
| Business Fax Number: | |
| Mailing Address: | 2155 State Route 22b, MORRISONVILLE |
| State: | NY |
| Postal Code: | 129623417 |
| Phone Number: | 5185638000 |
| Fax Number: | |
| NPI Enumeration Date: | 02/10/2016 |
| NPI Last Update Date: | 02/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | P00734 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |