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Individual

SAMANTHA GAIL THORESON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
IADC

Contact information

Practice address
703 16TH ST, SPIRIT LAKE, IA 51360-1623
(800) 592-0180
(712) 566-5229
Mailing address
PO BOX 36, ESTHERVILLE, IA 51334-0036
(800) 592-0180
(712) 566-5229

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21R022
IA
101YA0400X
Addiction (Substance Use Disorder) Counselor
303106
MN

Other

Enumeration date
11/19/2021
Last updated
11/19/2021
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