Individual
KELLY ANN STREET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
41 FAREWAY DR, NORTHFIELD, MN 55057-2643
(651) 278-1406
Mailing address
41 FAREWAY DR, NORTHFIELD, MN 55057-2643
(651) 278-1406
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/26/2022
Last updated
09/26/2022
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