Individual
MR. KEVIN JEFFERY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
21395 JOHN MILLESS DR. #400, ROGERS, MN 55374
(763) 424-1888
(763) 424-7288
Mailing address
21395 JOHN MILLESS DR. #400, ROGERS, MN 55374
(763) 424-1888
(763) 424-7288
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1269
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
258615100
—
MN
Enumeration date
10/16/2006
Last updated
10/10/2018
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