Individual
KELLY KENNEDY-JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
15489 45TH ST S, AFTON, MN 55001-9681
(612) 367-6046
Mailing address
1308 DELAWARE AVE, SAINT PAUL, MN 55118-2063
(320) 241-7799
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC03678
MN
Other
Enumeration date
03/27/2023
Last updated
03/27/2023
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