Provider Demographics
NPI:1013620228
Name:SANTRY, SAMARA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SAMARA
Middle Name:
Last Name:SANTRY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 EXTON RD
Mailing Address - Street 2:
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040-2509
Mailing Address - Country:US
Mailing Address - Phone:267-818-4200
Mailing Address - Fax:
Practice Address - Street 1:2300 COMPUTER RD STE H44
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1742
Practice Address - Country:US
Practice Address - Phone:267-818-4200
Practice Address - Fax:267-818-4201
Is Sole Proprietor?:No
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist