Individual
TASHA JEANMARIE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
2126 VISTA AVE, ARNEGARD, ND 58835
(701) 586-3300
Mailing address
4801 11TH AVE W APT 410, WILLISTON, ND 58801-5392
(406) 491-3610
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/20/2025
Last updated
02/20/2025
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