Individual
KELLY MARIE SHOWALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
8441 WAYZATA BLVD STE 140, GOLDEN VALLEY, MN 55426-1366
(651) 769-6300
(651) 759-6349
Mailing address
2497 7TH AVE E STE 108, NORTH ST PAUL, MN 55109-2949
(651) 769-6437
(651) 769-6599
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4444
MN
Other
Enumeration date
11/20/2024
Last updated
11/20/2024
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