| Sam Wilt, Llc | |
|
1704 Emory St Frederick MD 21701-9303 | |
| (240) 527-8539 | |
| Not Available |
| Full Name | Sam Wilt, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1704 Emory St, Frederick, Maryland |
| Authorized Official Name and Position | Samantha Wilt (OWNER) |
| Authorized Official Contact | 2405278539 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sam Wilt, Llc 1704 Emory St Frederick MD 21701-9303 Ph: (240) 527-8539 | Sam Wilt, Llc 1704 Emory St Frederick MD 21701-9303 Ph: (240) 527-8539 |
| NPI Number | 1063165199 |
|---|---|
| Provider Enumeration Date | 01/29/2022 |
| Last Update Date | 01/29/2022 |
| Certification Date | 01/29/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063165199 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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