Individual
MS. KIMBERLEY MARIE EDENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
1121 JACKSON ST NE, SUITE 105, MINNEAPOLIS, MN 55413-1672
(612) 236-1705
(612) 236-1701
Mailing address
763 2ND ST, HAMMOND, WI 54015-9781
(651) 270-2123
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
301386
MN
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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