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Individual

KELLY JO HAWSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LPC

Contact information

Practice address
1910 W HIGHWAY 61, BOX 283, GRAND MARAIS, MN 55604-7508
(218) 370-8773
(218) 387-2248
Mailing address
PO BOX 283, GRAND MARAIS, MN 55604-0283
(218) 370-8773
(218) 387-2248

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
00785
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1629482112
STEPS OF CHANGE LLC
MN
Enumeration date
03/11/2014
Last updated
01/02/2019
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