Provider Demographics
NPI:1245502475
Name:ZAID, SAMANTHA J (LMFT)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:J
Last Name:ZAID
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9140 BALTIMORE ST NE
Mailing Address - Street 2:SUITE 140, OFFICE 1406
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-4382
Mailing Address - Country:US
Mailing Address - Phone:651-356-0107
Mailing Address - Fax:
Practice Address - Street 1:9140 BALTIMORE ST NE
Practice Address - Street 2:SUITE 140, OFFICE 1406
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-4382
Practice Address - Country:US
Practice Address - Phone:651-356-0107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-03
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1873106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist