Individual
KELSEY ELIEL MARTIN-LARMOUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1246 UNIVERSITY AVE W, SAINT PAUL, MN 55104-4125
(651) 404-2133
Mailing address
1246 UNIVERSITY AVE W, SAINT PAUL, MN 55104-4125
(651) 404-2133
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305631
MN
Other
Enumeration date
10/14/2020
Last updated
10/14/2020
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