Individual
TIFFANY SAMUELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, CADC
Contact information
Practice address
1021 NEBRASKA ST, SIOUX CITY, IA 51105-1436
(122) 522-4777
(712) 252-5920
Mailing address
3320 W 4TH ST, SIOUX CITY, IA 51103-3200
(712) 202-0777
(712) 234-2399
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13042
IA
1041C0700X
Clinical Social Worker
073276
IA
Other
Enumeration date
03/18/2016
Last updated
10/30/2019
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