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Individual

LAURA B KEGLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW, LICSW

Contact information

Practice address
151 W BURNSVILLE PKWY STE 100, BURNSVILLE, MN 55337-2525
(952) 564-3000
(651) 925-0256
Mailing address
151 W BURNSVILLE PKWY STE 100, BURNSVILLE, MN 55337-2525
(952) 564-3000
(651) 925-0256

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
21215
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
21215
LICSW
MN
Enumeration date
06/12/2015
Last updated
06/12/2015
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