| Doctor Name: | SAMANTHA TAHIRAK |
| NPI Number: | 1518356120 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 800 Macdade Blvd Collingdale, PA - 190233826 |
| Business Phone Number: | 6109389379 |
| Business Fax Number: | |
| Mailing Address: | 548 S 49th St Apt 1r, PHILADELPHIA |
| State: | PA |
| Postal Code: | 191431688 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/20/2015 |
| NPI Last Update Date: | 01/20/2015 |
| 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: | |