Individual
SAMANTHA JEANNE WANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3777 COON RAPIDS BLVD NW STE 120, COON RAPIDS, MN 55433-2630
(612) 429-6686
Mailing address
3777 COON RAPIDS BLVD NW STE 120, COON RAPIDS, MN 55433-2630
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0414
MN
Other
Enumeration date
01/09/2020
Last updated
11/25/2025
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