Individual
MRS. KELLI ANN GAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW LICSW
Contact information
Practice address
1010 32ND AVE S, MOORHEAD, MN 56560
(218) 233-7524
(218) 233-8627
Mailing address
4625 HUNTERS PT, MOORHEAD, MN 56560
(701) 371-5305
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17810
MN
Other
Enumeration date
09/15/2008
Last updated
09/15/2008
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