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General NPI Number Information
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NPI Number | 1811506819
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Entity Type | Individual
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Provider Name | KELLY L LAFELL LGSW
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Gender | Female
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Dates
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Enumeration Date | 07/24/2020
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Last Update Date | 07/24/2020
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Provider Practice Location Address
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Address Line | 790 CLEVELAND AVE S STE 211
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City | SAINT PAUL
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State | MN
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Zip | 55116-3845
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Country | US
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Telephone | 612-245-4683
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Fax |
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Provider Business Mailing Address
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Address Line | 3239 COLFAX AVE N
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City | MINNEAPOLIS
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State | MN
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Zip | 55412-2543
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Country | US
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Telephone | 612-916-2713
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 28688
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License Number State | MN
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