Provider Demographics
NPI:1568615045
Name:ROBLER, SAMANTHA KLEINDIENST (AUD, PHD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:KLEINDIENST
Last Name:ROBLER
Suffix:
Gender:F
Credentials:AUD, PHD
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:
Other - Last Name:KLEINDIENST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 966
Mailing Address - Street 2:
Mailing Address - City:NOME
Mailing Address - State:AK
Mailing Address - Zip Code:99762-0966
Mailing Address - Country:US
Mailing Address - Phone:907-443-3311
Mailing Address - Fax:907-443-3723
Practice Address - Street 1:1000 GREG KRUSCHEK AVE
Practice Address - Street 2:
Practice Address - City:NOME
Practice Address - State:AK
Practice Address - Zip Code:99762-0966
Practice Address - Country:US
Practice Address - Phone:907-443-3311
Practice Address - Fax:907-443-3723
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X, 390200000X
AKAUDA111231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1570969Medicaid