Individual
ALICE SAMUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2230 COMO AVE, SAINT PAUL, MN 55108-1720
(651) 645-5323
Mailing address
2265 COMO AVE, SAINT PAUL, MN 55108-1737
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/02/2022
Last updated
09/02/2022
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