Organization
ECLECTIC DRAGONFLY THERAPY SERVICES, PLLC
Active
Other names
Eclectic Dragonfly Therapy Services
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE KELLY-FADDLER LPCC (OWNER/PSYCHOTHERAPIST)
(763) 482-1185
Entity
Organization
Contact information
Practice address
108 6TH AVE S, PRINCETON, MN 55371-1820
(763) 482-1185
Mailing address
PO BOX 213, PRINCETON, MN 55371-0213
(763) 482-1185
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
00842
MN
Other
Enumeration date
12/26/2015
Last updated
12/26/2015
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