Individual
KYAN BODDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7920 OLD CEDAR AVE S, BLOOMINGTON, MN 55425-1207
(952) 428-1800
(952) 428-1723
Mailing address
PO BOX 43, MINNEAPOLIS, MN 55440-0043
(612) 262-1166
(612) 262-4258
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
16457
MN
Other
Enumeration date
09/30/2010
Last updated
04/04/2024
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