Individual
BRENNA L EDGEWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2264 RIVER ROCK LN, SHAKOPEE, MN 55379-3639
(651) 468-5498
Mailing address
2264 RIVER ROCK LN, SHAKOPEE, MN 55379-3639
(651) 468-5498
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
23990
MN
Other
Enumeration date
03/14/2023
Last updated
03/14/2023
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