Provider Demographics
NPI:1699916726
Name:RODMAN, SAMANTHA ALISON (PHD)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:ALISON
Last Name:RODMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:SAMANTHA
Other - Middle Name:ALISON
Other - Last Name:LEVINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1122 OLD STONE LN
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-2054
Mailing Address - Country:US
Mailing Address - Phone:917-664-9223
Mailing Address - Fax:410-757-5184
Practice Address - Street 1:1122 OLD STONE LN
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-2054
Practice Address - Country:US
Practice Address - Phone:917-664-9223
Practice Address - Fax:410-757-5184
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-19
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor