Individual
KELLY GATES WILLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
333 SMITH AVENUE, UNITED HOSPITAL, SAINT PAUL, MN 55102
(651) 241-8290
Mailing address
3526 COACHMAN RD, EAGAN, MN 55122-1212
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5634
MN
Other
Enumeration date
04/29/2008
Last updated
04/29/2008
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