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Individual

SAMUEL PAUL WELLMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, LPCC

Contact information

Practice address
600 TWELVE OAKS CENTER DR STE 642H, WAYZATA, MN 55391-4512
(952) 451-7267
Mailing address
600 TWELVE OAKS CENTER DR STE 642H, WAYZATA, MN 55391-4512
(952) 451-7267

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2330
MN
103TC1900X
Counseling Psychologist
Primary
2330
MN

Other

Enumeration date
01/07/2020
Last updated
03/25/2020
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