Individual
SHELBY EDEVOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11660 ROUND LAKE BLVD NW, COON RAPIDS, MN 55433-2638
(763) 767-3350
Mailing address
11660 ROUND LAKE BLVD NW, COON RAPIDS, MN 55433-2638
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/13/2020
Last updated
05/13/2020
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