Individual
KELLY LEE ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
3701 SHORELINE DR STE 102A, 102A, WAYZATA, MN 55391-4000
(651) 231-7471
Mailing address
3701 SHORELINE DR STE 102A, 102A, WAYZATA, MN 55391-4000
(651) 231-7471
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
106H00000X
Marriage & Family Therapist
2494
MN
Other
Enumeration date
07/03/2012
Last updated
05/30/2024
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