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NPI Code Detail

MEDICARE: SAMANTHA RAE LECLAIR

MEDICARE: SAMANTHA RAE LECLAIR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-23-316938MN
2373H00000XDay Training/Habilitation SpecialistMN

General Provider Information

NPI Number : 1578274338
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA RAE LECLAIR
Provider Business Mailing Address
First Line : 1105 W RUSSELL ST
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57104-1322
Country : US
Telephone Number : 605-271-2690
Fax Number :
Provider Business Practice Location Address
First Line : 226 PARK AVE S STE 200
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56301-3713
Country : US
Telephone Number : 320-452-9392
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2022
Last Update Date : 12/09/2025

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Directions to “ SAMANTHA RAE LECLAIR ” Practice Location

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