Individual
MARYA SAMUELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., LPCC
Contact information
Practice address
3141 E BDE MAKA SKA PKWY, MINNEAPOLIS, MN 55408-2514
(952) 994-8114
Mailing address
3141 E BDE MAKA SKA PKWY, MINNEAPOLIS, MN 55408-2514
(952) 994-8114
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
3288
CA
101YM0800X
Mental Health Counselor
Primary
780
MN
101YP2500X
Professional Counselor
3288
CA
101YP2500X
Professional Counselor
780
MN
Other
Enumeration date
04/17/2014
Last updated
04/27/2022
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