Individual
SHELLY L EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LP
Contact information
Practice address
14115 JAMES RD STE 305, ROGERS, MN 55374-9417
(763) 575-8086
(320) 774-0415
Mailing address
14115 JAMES RD STE 305, ROGERS, MN 55374-9417
(763) 575-8086
(320) 774-0415
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3435
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023461
PREFERRED ONE
—
01
—
11Q62ED
BCBS
MN
01
—
120585
UCARE
—
01
—
6252137
UBH
—
05
—
63325900
—
MN
01
—
HP23171
HEALTH PARTNERS
—
Enumeration date
04/07/2006
Last updated
10/24/2018
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