Individual
KELLY WESNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
7200 FORESTVIEW LN N, MAPLE GROVE, MN 55369-5571
(763) 200-1466
Mailing address
7123 POLARIS LN N, MAPLE GROVE, MN 55311-3224
(612) 309-5527
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17743
MN
Other
Enumeration date
06/16/2015
Last updated
06/16/2015
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