Provider Demographics
NPI:1891499398
Name:SAMA, BLANCHE AMEI
Entity type:Individual
Prefix:
First Name:BLANCHE
Middle Name:AMEI
Last Name:SAMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7540 NEWBERRY LN
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3769
Mailing Address - Country:US
Mailing Address - Phone:240-790-2862
Mailing Address - Fax:
Practice Address - Street 1:6300 HEADEN JORDAN AVE
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1431
Practice Address - Country:US
Practice Address - Phone:240-658-5638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-28
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251S00000XAgenciesCommunity/Behavioral Health