Provider Demographics
NPI:1770566473
Name:DELLINGER, SAMANTHA GAYLE (PSYD)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:GAYLE
Last Name:DELLINGER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15700 NOBLE POINT DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99516-7545
Mailing Address - Country:US
Mailing Address - Phone:954-806-3319
Mailing Address - Fax:
Practice Address - Street 1:15700 NOBLE POINT DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99516-7545
Practice Address - Country:US
Practice Address - Phone:954-806-3319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK201880103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVAD000Medicare UPIN