Individual
MRS. KELLY KIMBERLY BENNETT-AURDAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
26713 138TH PL SE, KENT, WA 98042-8056
(206) 335-3011
Mailing address
26713 138TH PL SE, KENT, WA 98042-8056
(206) 335-3011
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW60160458
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1980994
—
WA
Enumeration date
09/24/2008
Last updated
03/16/2015
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