Sam, Melissa Marie

Sam, Melissa Marie is an individual health care provider with primary practice located at Cr 7165 Rd 3 #14 , Bloomfield NM 87413-8741. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Sam, Melissa Marie can be contacted via phone (505) 486-4304.

Contact Information

Primary practice address
Cr 7165 Rd 3 #14 Bloomfield NM 87413-8741
Phone: (505) 486-4304
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X

Profile Details

NPI number 1114552676
LBN Legal business name Sam, Melissa Marie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 5th, 2020
Last updated Mar 5th, 2020 - about 6 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 1114552676 NPPES
New Mexico Other 505793579 DRIVERS LICENCE

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