Organization
SAMPSON PA
Active
Organization
SAMPSON PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND N SAMPSON PHD LICENSED PSYCHOL (CEO OWNER)
(218) 262-4453
Entity
Organization
Contact information
Practice address
914 MINNESOTA ST, HIBBING, MN 55746
(218) 262-4453
Mailing address
225 1ST ST N, SUITE 3100, VIRGINIA, MN 55792
(218) 741-3740
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP1373
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6118559
UBH
MN
01
—
8L848SA
BCBS
MN
Enumeration date
05/11/2007
Last updated
08/22/2020
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