Individual
SHANNON ODEAN SAMSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18050 121ST AVE SW, DES LACS, ND 58733-9418
(701) 720-0695
Mailing address
18050 121ST AVE SW, DES LACS, ND 58733-9418
(701) 720-0695
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
07/01/2026
Last updated
07/01/2026
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