Individual
JENNA MARIE EDLUND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
9352 OAK AVE, WACONIA, MN 55387-9422
(952) 955-4714
Mailing address
9352 OAK AVE, WACONIA, MN 55387-9422
(952) 955-4714
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
LP6329
MN
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
LP6329
MN
Other
Enumeration date
07/06/2017
Last updated
11/05/2018
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