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1184294670
KELLY JOHNSON
FARGO, ND
NPI
1184294670
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Former Name
KELLY ROSS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ND 6079)
Enumeration Date
2021-06-28
Last Update Date
2022-08-19
Business Address
KELLY JOHNSON
1635 43RD ST S STE 105
FARGO, ND 58103-3579
Phone number: 701-412-2973
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Mailing Address
KELLY JOHNSON
1547 30TH AVE S
MOORHEAD, MN 56560-5149
Phone number: 218-287-4338
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