Most Relevant Information
Provider Data
| NPI Number: | 1003211988 |
| Provider Name: | SAMANTHA RENEE CARLSON |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/04/2014 |
| Last Updated: | 04/22/2021 |
Provider Practice Location
21 MUNICIPAL DR
ARNOLD
MO
630101012
Practice Location Phone/Fax
| Phone: | 6362966206 |
| Fax: | 6362960102 |
Provider Mailing Location
227 E MAIN ST
FESTUS
MO
630281952
Provider Mailing Phone/Fax
| Phone: | 6369312700 |
| Fax: | 6369315304 |