Individual
MS. KATHLEEN JO PENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
4710 WHITE BEAR PKWY, WHITE BEAR LAKE, MN 55110-3485
(651) 443-9290
Mailing address
5625 138TH ST N, HUGO, MN 55038-8200
(651) 387-6244
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC04005
MN
Other
Enumeration date
03/22/2024
Last updated
03/22/2024
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