Individual
ELIZABETH SAMUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
6442 CITY WEST PKWY STE 200, EDEN PRAIRIE, MN 55344-2809
(763) 318-2788
Mailing address
6442 CITY WEST PKWY STE 200, EDEN PRAIRIE, MN 55344-2809
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11880-123
WI
1041C0700X
Clinical Social Worker
29063
MN
Other
Enumeration date
03/18/2024
Last updated
08/14/2024
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