Individual
MRS. KELLY MARIE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1517 HIGHWAY 13 E, BURNSVILLE, MN 55337-2917
(612) 756-9107
Mailing address
1517 HIGHWAY 13 E, BURNSVILLE, MN 55337-2917
(612) 756-9107
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
MN
235Z00000X
Speech-Language Pathologist
Primary
LL00004054
WA
Other
Enumeration date
12/14/2006
Last updated
06/08/2026
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