Individual
DAVID KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 COMMERCE DR STE 260, WOODBURY, MN 55125-9243
(651) 328-6961
Mailing address
700 COMMERCE DR STE 260, WOODBURY, MN 55125-9243
(651) 328-6961
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP6036
MN
Other
Enumeration date
09/26/2016
Last updated
09/26/2016
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