Individual
SERENE EIDEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1068 LAKE ST S STE 109, FOREST LAKE, MN 55025-2633
(651) 982-4792
(651) 982-6035
Mailing address
1906 IGLEHART AVE, SAINT PAUL, MN 55104-5139
(651) 313-1898
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
32549
MN
Other
Enumeration date
05/20/2026
Last updated
05/20/2026
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