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General NPI Number Information
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NPI Number | 1427530666
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Entity Type | Individual
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Provider Name | KELLI HOWARD PHD, LP
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Gender | Female
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Dates
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Enumeration Date | 09/04/2018
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Last Update Date | 12/15/2022
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Provider Practice Location Address
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Address Line | 209 CHURCHILL ST W STE 102
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City | STILLWATER
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State | MN
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Zip | 55082-6216
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Country | US
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Telephone | 651-323-1563
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Fax |
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Provider Business Mailing Address
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Address Line | 209 CHURCHILL ST W STE 102
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City | STILLWATER
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State | MN
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Zip | 55082-6216
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Country | US
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Telephone | 651-323-1563
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | LP6270
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License Number State | MN
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