Provider Demographics
NPI:1669141735
Name:SANCHEZ, SAMANTHA LIN
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:LIN
Last Name:SANCHEZ
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 1:120 HULST DRIVE
Mailing Address - Street 2:
Mailing Address - City:MATAMORAS
Mailing Address - State:PA
Mailing Address - Zip Code:18336
Mailing Address - Country:US
Mailing Address - Phone:570-491-5454
Mailing Address - Fax:570-491-5706
Practice Address - Street 1:120 HULST DRIVE
Practice Address - Street 2:
Practice Address - City:MATAMORAS
Practice Address - State:PA
Practice Address - Zip Code:18336
Practice Address - Country:US
Practice Address - Phone:570-491-5454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF03801237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist