Provider Demographics
NPI:1962655068
Name:WASCOW, SAMANTHA ALEXIS (MSS)
Entity Type:Individual
Prefix:MISS
First Name:SAMANTHA
Middle Name:ALEXIS
Last Name:WASCOW
Suffix:
Gender:F
Credentials:MSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2288 2ND STREET PIKE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-4108
Mailing Address - Country:US
Mailing Address - Phone:215-598-7745
Mailing Address - Fax:
Practice Address - Street 1:2288 SECOND STREET PIKE
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-4108
Practice Address - Country:US
Practice Address - Phone:215-579-7745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst