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General NPI Number Information
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NPI Number | 1245502475
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Entity Type | Individual
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Provider Name | SAMANTHA J ZAID LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/03/2012
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Last Update Date | 11/20/2012
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Provider Practice Location Address
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Address Line | 9140 BALTIMORE ST NE SUITE 140, OFFICE 1406
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City | BLAINE
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State | MN
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Zip | 55449-4382
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Country | US
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Telephone | 651-356-0107
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Fax |
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Provider Business Mailing Address
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Address Line | 9140 BALTIMORE ST NE SUITE 140, OFFICE 1406
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City | BLAINE
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State | MN
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Zip | 55449-4382
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Country | US
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Telephone | 651-356-0107
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1873
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License Number State | MN
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