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General NPI Number Information
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NPI Number | 1841106127
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Entity Type | Individual
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Provider Name | SAMANTHA GERRING
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Gender | Female
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Dates
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Enumeration Date | 08/19/2026
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Last Update Date | 08/19/2026
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Provider Practice Location Address
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Address Line | 233 W 1ST ST
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City | WACONIA
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State | MN
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Zip | 55387-1302
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Country | US
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Telephone | 651-734-9633
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Fax | 651-734-9533
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Provider Business Mailing Address
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Address Line | 2101 WOODDALE DR STE B
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City | WOODBURY
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State | MN
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Zip | 55125-4442
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Country | US
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Telephone | 651-734-9633
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Fax | 651-734-9533
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 304980
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License Number State | MN
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