Individual
MRS. KERRY EDNA MCDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
5208 BLOOMINGTON AVE S, MINNEAPOLIS, MN 55417
(612) 205-9745
(612) 822-2116
Mailing address
5208 BLOOMINGTON AVE S, MINNEAPOLIS, MN 55417
(612) 205-9745
(612) 822-2116
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13929
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
924691600
—
MN
Enumeration date
09/28/2006
Last updated
05/01/2017
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