Provider Demographics
NPI:1255518148
Name:TRUEDSON, LEANNE BETH (MSW, LGSW)
Entity type:Individual
Prefix:MRS
First Name:LEANNE
Middle Name:BETH
Last Name:TRUEDSON
Suffix:
Gender:F
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 PRAIRIE AVE.
Mailing Address - Street 2:PO BOX 3
Mailing Address - City:KENNEDY
Mailing Address - State:MN
Mailing Address - Zip Code:56733-0003
Mailing Address - Country:US
Mailing Address - Phone:218-674-4405
Mailing Address - Fax:
Practice Address - Street 1:444 N ASH
Practice Address - Street 2:
Practice Address - City:HALLOCK
Practice Address - State:MN
Practice Address - Zip Code:56728
Practice Address - Country:US
Practice Address - Phone:218-843-3682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN142161041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool