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Individual
KELLY METTAYER
Active
Individual
KELLY METTAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
301614
MN
Other
Enumeration date
07/25/2013
Last updated
07/23/2026
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