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Individual

SAMANTHA LYNN BEAUCHMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
300 2ND AVE NE, JAMESTOWN, ND 58401-3373
(701) 253-4000
(701) 952-6019
Mailing address
PO BOX 2168, FARGO, ND 58107-2168
(701) 234-2119

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
1400
KS
103T00000X
Psychologist
Primary
497
ND
103T00000X
Psychologist
LP5687
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
17563
ND
05
1922387950
MN
Enumeration date
08/08/2011
Last updated
09/30/2020
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