Provider Demographics
NPI:1366539926
Name:ABRAMS, SAMANTHA MAIERLE (PHD)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:MAIERLE
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:SAMANTHA
Other - Middle Name:P
Other - Last Name:SUFFOLETTA-MAIERLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PH D
Mailing Address - Street 1:1154 HOLLY BEND DR
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7957
Mailing Address - Country:US
Mailing Address - Phone:843-452-0669
Mailing Address - Fax:
Practice Address - Street 1:1154 HOLLY BEND DR
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-7957
Practice Address - Country:US
Practice Address - Phone:843-452-0669
Practice Address - Fax:843-278-5107
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC000883103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical