Provider Demographics
NPI:1871317636
Name:DART, SAMANTHA MARIE (AUD)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:MARIE
Last Name:DART
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 OAKDALE ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-5109
Mailing Address - Country:US
Mailing Address - Phone:508-838-7550
Mailing Address - Fax:
Practice Address - Street 1:10 DORRANCE ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-2018
Practice Address - Country:US
Practice Address - Phone:855-971-0451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAUD00294231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist