Individual
SAMANTHA WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC-S
Contact information
Practice address
1340 HAZEL ST N, SAINT PAUL, MN 55119-4506
(763) 339-7506
Mailing address
1845 OLD HUDSON RD APT 102, SAINT PAUL, MN 55119-4319
(612) 459-3845
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
30610
MN
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
07/13/2018
Last updated
12/12/2023
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