Provider Demographics
NPI:1710322375
Name:WINTON, SAMANTHA MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:MARIE
Last Name:WINTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 5TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-6904
Mailing Address - Country:US
Mailing Address - Phone:727-490-8811
Mailing Address - Fax:
Practice Address - Street 1:2620 5TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-6904
Practice Address - Country:US
Practice Address - Phone:727-490-8811
Practice Address - Fax:727-290-4920
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-08
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9464103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist