Individual
ELLEN FAYE SAMUELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
822 S 3RD ST STE 100, MINNEAPOLIS, MN 55415-1200
(612) 217-1667
Mailing address
822 S 3RD ST STE 100, MINNEAPOLIS, MN 55415-1200
(612) 217-1667
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/08/2023
Last updated
03/08/2023
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