Individual
SAMANTHA LEE WOLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
110 6TH AVE S # 100, SAINT CLOUD, MN 56301-5209
(320) 253-5930
Mailing address
116 COLE CT, MANKATO, MN 56001-6426
(507) 779-9001
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4387
MN
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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