Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist |
NPI | 1114562949 |
---|---|
Provider Name | Samantha Rene Murphy |
First Address | Anchorage, AK 99521-2006 |
Second Address | Fairbanks, AK 99701-7376 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2019 |
Last Update Date | 15/11/2019 |