Individual
MRS. KELLY CAMERON LINDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
407 WASHINGTON ST, MONTICELLO, MN 55362-8815
(763) 295-4001
(763) 295-5086
Mailing address
407 WASHINGTON ST, MONTICELLO, MN 55362-8815
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302082
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
302082
LADC
MN
Enumeration date
02/14/2008
Last updated
10/30/2012
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