Individual provider · Type 1 NPI
Kelly Willmott, LADC
Addiction (Substance Use Disorder) Counselor · Prior Lake, MN
NPI number
1780929547
Active
Practice location
16221 Main Ave SE, Suite 102
Prior Lake, MN 55372-1777
Fax (952) 440-6037
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 302238 (MN) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1780929547
Kelly Willmott, LADC's National Provider Identifier is 1780929547, issued on Dec 5, 2012. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Prior Lake, MN. The record was last updated on Dec 5, 2012.