Provider Demographics
NPI:1053919811
Name:REAP, SAMANTHA LYNN (ND)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:LYNN
Last Name:REAP
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E FRONT ST STE 509A
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-5209
Mailing Address - Country:US
Mailing Address - Phone:406-533-5112
Mailing Address - Fax:833-468-0041
Practice Address - Street 1:501 E FRONT ST STE 509A
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-5209
Practice Address - Country:US
Practice Address - Phone:406-533-5112
Practice Address - Fax:833-468-0041
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-14
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTAHC-NAT-LIC-2133175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath