Provider Demographics
NPI:1821793548
Name:ATWOOD, SAMANTHA
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:ATWOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2156 E 3480 S
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-1292
Mailing Address - Country:US
Mailing Address - Phone:801-520-3867
Mailing Address - Fax:
Practice Address - Street 1:245 EAST. 680 SOUTH.
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UTAH
Practice Address - Zip Code:84720
Practice Address - Country:UM
Practice Address - Phone:435-867-7654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health