Provider Demographics
NPI:1588232185
Name:KRAHLING, SAMANTHA JO (MS)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:JO
Last Name:KRAHLING
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 E GIRARD AVE
Mailing Address - Street 2:APT 2
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125
Mailing Address - Country:US
Mailing Address - Phone:301-752-9940
Mailing Address - Fax:
Practice Address - Street 1:1 SOUTH PENN SQUARE
Practice Address - Street 2:SUITE 960
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107
Practice Address - Country:US
Practice Address - Phone:215-351-2331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAGC0331710170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS