Individual
MS. KELLY SUMMERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
950 COUNTY HIGHWAY 10, 108, SPRING LAKE PARK, MN 55432-1253
(763) 355-5092
Mailing address
950 COUNTY HIGHWAY 10, 108, SPRING LAKE PARK, MN 55432-1253
(763) 355-5092
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302446
MN
Other
Enumeration date
10/18/2010
Last updated
10/18/2010
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