Provider Demographics
NPI:1871067454
Name:SAMAHA, ANDREW LAWRENCE (PHD, BCBA-D)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:LAWRENCE
Last Name:SAMAHA
Suffix:
Gender:M
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2161
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34230-2161
Mailing Address - Country:US
Mailing Address - Phone:239-218-0627
Mailing Address - Fax:
Practice Address - Street 1:253 S LINKS AVE UNIT B
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-6926
Practice Address - Country:US
Practice Address - Phone:941-404-3721
Practice Address - Fax:941-296-7285
Is Sole Proprietor?:No
Enumeration Date:2019-01-16
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst