Individual
CHRISTINA MARIE KELLY-JACKELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
8455 FLYING CLOUD DR, EDEN PRAIRIE, MN 55344-3974
(952) 993-7400
Mailing address
8455 FLYING CLOUD DR, EDEN PRAIRIE, MN 55344-3974
(952) 993-7400
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
18535
MN
Other
Enumeration date
01/26/2010
Last updated
05/03/2019
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