Provider Demographics
NPI:1477992394
Name:SATTLER, SAMANTHA
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:SATTLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:
Other - Last Name:SHANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5800 MONROE ST STE A9
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2208
Mailing Address - Country:US
Mailing Address - Phone:419-460-0621
Mailing Address - Fax:419-482-1262
Practice Address - Street 1:5800 MONROE ST STE A9
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2208
Practice Address - Country:US
Practice Address - Phone:419-460-0621
Practice Address - Fax:419-482-1262
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1901534101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional