Individual
MARY LISA CHEDDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LMFT
Contact information
Practice address
1500 MCANDREWS RD W STE 215, BURNSVILLE, MN 55337-4445
(952) 222-3002
Mailing address
1500 MCANDREWS RD W STE 215, BURNSVILLE, MN 55337-4445
(952) 222-3002
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4291
MN
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033821632
—
MN
Enumeration date
02/22/2017
Last updated
01/18/2024
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