Provider Demographics
NPI:1538896774
Name:BRADEN, SAMANTHA LYNN (AUD)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:LYNN
Last Name:BRADEN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:SAMANTHA
Other - Middle Name:LYNN
Other - Last Name:REDMOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:621 S NEW BALLAS RD STE 385A
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8214
Mailing Address - Country:US
Mailing Address - Phone:314-251-5850
Mailing Address - Fax:314-251-5992
Practice Address - Street 1:615 S NEW BALLAS RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8221
Practice Address - Country:US
Practice Address - Phone:314-251-5850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022030617231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist