Individual
DR. WAYNE D SAMUELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1351 PAGE DR S STE 105, FARGO, ND 58103-3536
(701) 893-3419
Mailing address
1351 PAGE DR S STE 105, FARGO, ND 58103-3536
(701) 893-3419
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
75
ND
Other
Enumeration date
01/23/2006
Last updated
11/07/2007
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