Individual
SAMANTHA ANN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1906 E BROADWAY AVE STE 1, BISMARCK, ND 58501-4740
(701) 415-6233
(833) 525-1920
Mailing address
1906 E BROADWAY AVE STE 1, BISMARCK, ND 58501-4740
(701) 415-6233
(833) 525-1920
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
DUM00000
ND
175T00000X
Peer Specialist
Primary
—
ND
Other
Enumeration date
03/20/2024
Last updated
03/20/2024
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