Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 1127 | NM |
NPI | 1063847598 |
---|---|
Provider Name | Dr. Maria Katherine Samaras |
First Address | Albuquerque, NM 87125-6666 |
Second Address | Albuquerque, NM 87110-7613 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2013 |
Last Update Date | 27/11/2017 |