Individual
SAMANTHA WOMELDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC, LPCC
Contact information
Practice address
1045 STOUGHTON AVE, CHASKA, MN 55318-2149
(952) 448-6557
(952) 448-6047
Mailing address
102 E 2ND ST, CHASKA, MN 55318-1906
(952) 856-3932
(952) 448-6047
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
305744
MN
101YP2500X
Professional Counselor
Primary
3690
MN
Other
Enumeration date
02/08/2023
Last updated
02/08/2023
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