Individual
KATHLEEN MARY CONLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.I.C.S.W.
Contact information
Practice address
3919 W 44TH ST STE 200, EDINA, MN 55424-1032
(952) 922-1977
(952) 922-1980
Mailing address
3919 W 44TH ST STE 200, EDINA, MN 55424-1032
(952) 922-1977
(952) 922-1980
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5735
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5H605CO
BLUE SHIELD INDIVIDUAL
MN
Enumeration date
04/25/2007
Last updated
07/08/2007
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