Individual
SAMATALIS HUSSEIN HAILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPCC
Contact information
Practice address
110 DIVISION ST, WAITE PARK, MN 56387-1330
(612) 735-6673
Mailing address
110 DIVISION ST, WAITE PARK, MN 56387-1330
(612) 735-6673
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
02336
MN
101YP2500X
Professional Counselor
02336
MN
101YP2500X
Professional Counselor
Primary
3240
MN
Other
Enumeration date
11/23/2021
Last updated
07/02/2024
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