Individual
GWEN N FEDDEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1900 CENTRACARE CIR, SAINT CLOUD, MN 56303-5000
(320) 229-4918
Mailing address
1900 CENTRACARE CIR, SAINT CLOUD, MN 56303-5000
(320) 229-4918
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
14698
MN
1041C0700X
Clinical Social Worker
14698
—
Other
Enumeration date
09/07/2022
Last updated
09/07/2022
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