Provider Demographics
NPI:1326568635
Name:STEFFEN, SAMANTHA NICOLE (MA)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:NICOLE
Last Name:STEFFEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3244 CONCORD ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-3493
Mailing Address - Country:US
Mailing Address - Phone:734-771-6265
Mailing Address - Fax:
Practice Address - Street 1:3244 CONCORD
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183
Practice Address - Country:US
Practice Address - Phone:734-771-6265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician