Provider Demographics
NPI:1326386467
Name:REMMEL, KELSEY MEGAN (LSW)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:MEGAN
Last Name:REMMEL
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 NODAK DR S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-2366
Mailing Address - Country:US
Mailing Address - Phone:701-551-6337
Mailing Address - Fax:701-280-9520
Practice Address - Street 1:1112 NODAK DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-2366
Practice Address - Country:US
Practice Address - Phone:701-551-6337
Practice Address - Fax:701-280-9520
Is Sole Proprietor?:No
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4738104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker