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Individual
MISS KELLI GRACE KNUDSEN
Active
Individual
MISS KELLI GRACE KNUDSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, QMHP
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
L10639
OR
101YM0800X
Mental Health Counselor
LW61517630
WA
104100000X
Social Worker
L10639
OR
Other
Enumeration date
10/11/2017
Last updated
05/20/2026
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