Justin Shedivy

NPI #1174807333 in New Brighton, Minnesota

Provider Information

NPI Number: 1174807333
Entity Type: Individual
Name: Justin Shedivy
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Enumeration Date: Oct 6, 2011
Last Updated: Oct 6, 2011

Practice Location

Address: 1900 SILVER LAKE RD NW
Address 2: SUITE 110
City: New Brighton
State: Minnesota
ZIP Code: 55112-1786
Phone: (651) 628-9566

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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