Individual
SAMANTHA MARCINETTE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPCC
Contact information
Practice address
4225 TECHNOLOGY DR NW, BEMIDJI, MN 56601-5118
(218) 751-0281
(218) 751-0870
Mailing address
303 SE 1ST ST, GRAND RAPIDS, MN 55744-3681
(218) 380-7310
(218) 999-7068
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC02579
MN
Other
Enumeration date
09/22/2020
Last updated
09/22/2020
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