Individual
KELLY E KADLEC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EDD
Contact information
Practice address
700 1ST AVE S, FARGO, ND 58103-1802
(701) 234-4111
(701) 234-4130
Mailing address
700 1ST AVE S, FARGO, ND 58103-1802
(701) 234-4111
(701) 234-4130
Taxonomy
Speciality
Code
Description
License number
State
103TP0814X
Psychoanalysis Psychologist
Primary
349
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11724
—
ND
05
—
266913700
—
MN
Enumeration date
07/17/2006
Last updated
10/14/2008
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