Individual
SAMANTHA HOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1467 LAKE ST S, 300, FOREST LAKE, MN 55025-4505
(651) 982-1504
Mailing address
1467 LAKE ST S, 300, FOREST LAKE, MN 55025-4505
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
104938
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104938
TEMPORARY OCCUPATIONAL THERAPIST LICENSE
MN
Enumeration date
07/06/2015
Last updated
07/06/2015
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