Most Relevant Information
Provider Data
| NPI Number: | 1003584681 |
| Provider Name: | JAMONDA KELLY |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/31/2021 |
| Last Updated: | 08/31/2021 |
Provider Practice Location
3333 UNIVERSITY AVE SE
MINNEAPOLIS
MN
554143325
Practice Location Phone/Fax
| Phone: | 6123319413 |
| Fax: |
Provider Mailing Location
721 ALDRICH AVE N APT 201
MINNEAPOLIS
MN
554114225
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |