Individual
KATHLEEN ANN SAMILO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LP
Contact information
Practice address
1867 SAINT CLAIR AVE, SAINT PAUL, MN 55105-1642
(651) 402-3458
(763) 780-0784
Mailing address
1485 81ST AVE NE, SPRING LAKE PARK, MN 55432-2111
(763) 780-3036
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP 0249
MN
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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