Samantha Lyn Boutis PSY.D

NPI 1033353750 - Psychologist - 103TS0200X

NPI Details
NPI 1033353750
Gender Female
Enumeration Date 04/24/2009
Last Updated 09/08/2010
Entity Type Individual
Active Over 8 years ago
Practice Location
430 SILLS RD
YAPHANK NY, 11980, US
Phone (631) 924-5583
Fax
Business Location
430 SILLS RD
YAPHANK NY, 11980, US
Phone (631) 924-5583
Fax
Toxanomy
Taxonomy Code 103TS0200X
License State New York
License Number 297457
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According to our database, Dr. Samantha Lyn Boutis PSY.D NPI is 1033353750, taxonomy code is 103TS0200X and license number is 297457, license state is located at New York. Samantha Lyn Boutis PSY.D physically located at 430 Sills Rd, Yaphank NY, 11980. NPI Number Samantha Lyn Boutis PSY.D has the Individual type.

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1033353750 NPI number is provided on an as is basis without warranty of any kind. 1033353750 is maintained by the National Plan & Provider Enumeration System. The contents of Samantha Lyn Boutis PSY.D are for informational purposes only.