| Brendan Shane | |
|
7575 Golden Valley Rd Suite 370 Golden Valley MN 55427-4562 | |
| (952) 334-9390 | |
| Not Available |
| Full Name | Brendan Shane |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 7575 Golden Valley Rd, Golden Valley, Minnesota |
| Authorized Official Name and Position | Brendan C Shane (OWNER) |
| Authorized Official Contact | 9523349390 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brendan Shane 6513 Creek Dr Edina MN 55439-1207 Ph: (952) 334-9390 | Brendan Shane 7575 Golden Valley Rd Suite 370 Golden Valley MN 55427-4562 Ph: (952) 334-9390 |
| NPI Number | 1366840324 |
|---|---|
| Provider Enumeration Date | 12/08/2014 |
| Last Update Date | 12/08/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366840324 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 13192 (Minnesota) | Primary |
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