Provider Demographics
NPI:1558012799
Name:HANDORF, SAMANTHA JO (RBT)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:JO
Last Name:HANDORF
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:550 MOUNT ZION RD APT 295
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-4740
Mailing Address - Country:US
Mailing Address - Phone:513-658-5935
Mailing Address - Fax:
Practice Address - Street 1:563 CENTRE VIEW BLVD
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3444
Practice Address - Country:US
Practice Address - Phone:859-331-0329
Practice Address - Fax:859-331-0367
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician