Individual
DR. DOROTHY SUE EDELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D., L.P.
Contact information
Practice address
6120 EARLE BROWN DR, STE. 520, BROOKLYN CENTER, MN 55430-2123
(763) 531-0566
(763) 531-0602
Mailing address
6120 EARLE BROWN DR, STE. 520, BROOKLYN CENTER, MN 55430-2123
(763) 531-0566
(763) 531-0602
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LP3108
MN
103TC0700X
Clinical Psychologist
Primary
LP3108
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
385823500
—
MN
01
—
61-40441
MEDICA
MN
01
—
66B68ED
BLUECROSSBLUESHIELD
MN
05
—
97351777
—
MN
Enumeration date
11/12/2006
Last updated
11/17/2016
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