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Search › Indiana › 101YA0400X

Kimtoiya Sam, LCAC

NPI 1639622467 · on the registry since 2016 · sole proprietor

Practice

Address
3430 Cork Bend Dr
Indianapolis, IN 46239
Phone
(317) 966-7772
Organisation at this address
180 Enterprise
Integrated Mental Health And Addiction Treatment Services
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
101YA0400X
101YA0400X
Licence states on file
IN
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2016-07-28

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana