Individual
KELLY FERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15650 CEDAR AVE, APPLE VALLEY, MN 55124-7283
(612) 672-6999
Mailing address
1320 S FRONTAGE RD, HASTINGS, MN 55033-2684
(612) 500-0905
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
3326
MN
Other
Enumeration date
08/19/2016
Last updated
11/08/2018
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