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Individual

SHAWN KERN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LADC

Contact information

Practice address
7308 64TH AVE N, BROOKLYN PARK, MN 55428-2317
(612) 710-6510
Mailing address
7308 64TH AVE N, BROOKLYN PARK, MN 55428-2317
(612) 710-6510

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
306447
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
306447
BBHS
MN
Enumeration date
01/30/2023
Last updated
01/30/2023
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