Individual
AMANDA KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2344 HELEN ST N, NORTH ST PAUL, MN 55109-2942
(651) 773-5988
Mailing address
1509 SOUTHCROSS DR W, BURNSVILLE, MN 55306-6945
(952) 491-9810
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/03/2020
Last updated
08/03/2020
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