Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 017075 | NY |
Y | 103TC0700X | Clinical Psychologist | 017075 | NY |
NPI | 1013074079 |
---|---|
Provider Name | Dr. Samantha Stehle |
First Address | Mineola, NY 11501-1427 |
Second Address | Roslyn Heights, NY 11577-1356 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 16/03/2015 |