Provider Demographics
NPI:1427828540
Name:ARVIN, SAMANTHA DENISE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:DENISE
Last Name:ARVIN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 MARLANDWOOD RD APT 1137
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-3695
Mailing Address - Country:US
Mailing Address - Phone:850-758-7741
Mailing Address - Fax:
Practice Address - Street 1:7349 HONEYSUCKLE STE 100
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-5888
Practice Address - Country:US
Practice Address - Phone:254-780-9658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121926235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist