Individual
BRENDAN C SHANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LICSW
Contact information
Practice address
7575 GOLDEN VALLEY RD, GOLDEN VALLEY, MN 55427-4562
(952) 334-9390
Mailing address
6513 CREEK DR, EDINA, MN 55439-1207
(952) 983-0216
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13192
MN
Other
Enumeration date
01/30/2013
Last updated
01/30/2013
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