Vollertsen, Samantha Jean

Vollertsen, Samantha Jean is an sole proprietor health care provider with primary practice located at 2331 Hansen Court , Tallahassee FL 32301. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavioral Analyst, Behavioral Health & Social Service Providers / Behavior Technician. Behavioral Health & Social Service Providers / Behavior Technician is her primary health care specialty. Vollertsen, Samantha Jean can be contacted via phone (850) 320-6555.

Contact Information

Primary practice address
2331 Hansen Court Tallahassee FL 32301
Phone: (850) 320-6555
Fax: (888) 873-4610
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X 17-35394 Florida

Profile Details

NPI number 1821539115
LBN Legal business name Vollertsen, Samantha Jean
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 20th, 2017
Last updated Feb 12th, 2019 - about 7 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 1821539115 NPPES
Florida Other 17-35394 RBT
Florida MEDICAID 024665300 RBT

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