Depue, Samantha Fordham

Depue, Samantha Fordham is an individual health care provider with primary practice located at 3623 Calvin Dr , Columbus GA 31904-7915. She recently has 2 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Speech-Language Pathologist, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Depue, Samantha Fordham can be contacted via phone (706) 940-5100.

Contact Information

Primary practice address
3623 Calvin Dr Columbus GA 31904-7915
Phone: (706) 940-5100
Fax: (762) 208-7512
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP6138 Georgia
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-22-62671

Profile Details

NPI number 1114041613
LBN Legal business name Depue, Samantha Fordham
Credentials M.ED. CCC-SLP, BCBA
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 19th, 2007
Last updated Nov 21st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114041613 NPPES
Other 1-22-62671 BEHAVIOR ANALYST CERTIFICATION BOARD
Other SLP 6138 BEHAVIOR ANALYST CERTIFICATION BOARD

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