Provider Demographics
NPI:1780064105
Name:VROOMAN, SAMANTHA (AUD)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:VROOMAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1954 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-9336
Mailing Address - Country:US
Mailing Address - Phone:919-570-8311
Mailing Address - Fax:919-573-0797
Practice Address - Street 1:1954 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-9336
Practice Address - Country:US
Practice Address - Phone:919-570-8311
Practice Address - Fax:919-573-0797
Is Sole Proprietor?:No
Enumeration Date:2015-06-01
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11397231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist