Individual
MRS. KELLY SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPCC, RPT
Contact information
Practice address
220 RAILROAD ST SE, PINE CITY, MN 55063-1540
(320) 629-7600
(651) 925-0071
Mailing address
2463 180TH AVE, MORA, MN 55051-7219
(320) 291-7291
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC02023
MN
Other
Enumeration date
01/12/2019
Last updated
01/12/2019
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