Individual
CHRISTOPHER FENNEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LICSW
Contact information
Practice address
520 NW 5TH ST, BRAINERD, MN 56401-2902
(188) 293-2352
(218) 829-1368
Mailing address
520 NW 5TH ST, BRAINERD, MN 56401-2902
(182) 821-1412
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
25627
MN
1041C0700X
Clinical Social Worker
Primary
25627
MN
Other
Enumeration date
07/14/2021
Last updated
11/08/2023
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