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Individual

MS. JOANNA KELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., LMFT, RPT

Contact information

Practice address
12805 HWY 55 STE 216, PLYMOUTH, MN 55441-3859
(612) 440-1450
(612) 524-5563
Mailing address
15360 18TH AVE N APT 1010, PLYMOUTH, MN 55447-2473
(612) 961-1015
(612) 524-5563

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
3192
MN
106H00000X
Marriage & Family Therapist
Primary
3192
MN

Other

Enumeration date
11/29/2015
Last updated
10/29/2020
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