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Individual

KELLY DALLAIRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
425 S ADAMS ST STE 205, GREEN BAY, WI 54301-4117
(920) 737-7695
Mailing address
615 REID ST, DE PERE, WI 54115-1346
(920) 737-7695

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2419-226
WI
101YM0800X
Mental Health Counselor
Primary
7682-125
WI

Other

Enumeration date
02/05/2015
Last updated
06/02/2026
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