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Individual

EVAN MICHAEL KELLAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
11900 WAYZATA BLVD STE 130, MINNETONKA, MN 55305-2018
(612) 413-8780
Mailing address
11900 WAYZATA BLVD STE 130, MINNETONKA, MN 55305-2018
(612) 413-8780

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
11/09/2021
Last updated
11/09/2021
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