NPI 1003063751

Joni Lea Medenwald, MSWLSW

Practitioner Clinical Social Worker Moorhead, MN

Practice location

Address: 815 37th Ave S, Moorhead, MN 56560-5524
Phone: (701) 451-4811
Fax: (651) 925-0057
Mailing address: 1201 25th St S, Fargo, ND 58103-2311

Registered specialties (2)

Clinical Social Worker Primary

Behavioral Health & Social Service Providers Taxonomy 1041C0700X Licence 21692 (MN)

Other Social Worker providers in Minnesota →

Social Worker

Behavioral Health & Social Service Providers Taxonomy 104100000X Licence 3977 (ND)

Registry record

NPI: 1003063751
Entity type: Individual
Sex (as registered): Female
NPI issued: 25 Aug 2008
Record last updated: 25 Feb 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.