Individual
KAILLY ALLYCE BONNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS LADC LPCC
Contact information
Practice address
911 18TH ST N, SAINT CLOUD, MN 56303-1203
(320) 650-1550
Mailing address
126 17TH STREET CT, SAUK RAPIDS, MN 56379-2754
(218) 349-9975
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
304645
MN
101YM0800X
Mental Health Counselor
Primary
01951
MN
Other
Enumeration date
03/21/2017
Last updated
02/24/2020
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