Individual
SAMANTHA JOAN SCHULLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LGSW, LADC
Contact information
Practice address
2118 BLAISDELL AVE, MINNEAPOLIS, MN 55404-2415
(612) 286-0473
Mailing address
2118 BLAISDELL AVE, MINNEAPOLIS, MN 55404-2415
(612) 286-0473
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
306452
MN
Other
Enumeration date
08/25/2022
Last updated
08/25/2022
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