| Doctor Name: | DR. SAMANTHA TIMM |
| NPI Number: | 1326022864 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSYD |
| License Number: | 1242 |
| Business Practice Address: | 2200 Bergquist Dr Ste 1 59 Mdos/sgow Jbsa Lackland, TX - 782369908 |
| Business Phone Number: | 2102925968 |
| Business Fax Number: | |
| Mailing Address: | 2200 Bergquist Dr Ste 1, 59 Mdos/sgow JBSA LACKLAND |
| State: | TX |
| Postal Code: | 782369908 |
| Phone Number: | 2102925968 |
| Fax Number: | |
| NPI Enumeration Date: | 11/29/2005 |
| NPI Last Update Date: | 01/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 1242 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |