Provider Demographics
NPI:1326719899
Name:HAREMZA, SAMANTHA RENE
Entity Type:Individual
Prefix:MISS
First Name:SAMANTHA
Middle Name:RENE
Last Name:HAREMZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 WOMPOLE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-1556
Mailing Address - Country:US
Mailing Address - Phone:248-935-1661
Mailing Address - Fax:
Practice Address - Street 1:929 STEVENS ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48502-1620
Practice Address - Country:US
Practice Address - Phone:248-330-4621
Practice Address - Fax:248-524-8850
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator