Provider Demographics
NPI:1902112675
Name:GEDDES, EDNA MARIE (PSYD)
Entity Type:Individual
Prefix:MRS
First Name:EDNA
Middle Name:MARIE
Last Name:GEDDES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:EDNA
Other - Middle Name:
Other - Last Name:GEDDES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYE
Mailing Address - Street 1:9754 ALMOND AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-1842
Mailing Address - Country:US
Mailing Address - Phone:763-439-4925
Mailing Address - Fax:
Practice Address - Street 1:9754 ALMOND AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-1842
Practice Address - Country:US
Practice Address - Phone:763-439-4925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health