Individual
SHELLEY MARIE MYDRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., LMFT
Contact information
Practice address
5523 WINGWOOD CT, MINNETONKA, MN 55345-5660
(952) 484-1888
Mailing address
5523 WINGWOOD CT, MINNETONKA, MN 55345-5660
(952) 484-1888
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1861
MN
Other
Enumeration date
10/08/2010
Last updated
10/08/2010
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