Individual
KELLY ANN NORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-8196
(920) 674-6113
Mailing address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-8196
(920) 674-6113
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8042-123
WI
Other
Enumeration date
11/05/2010
Last updated
08/20/2013
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