Provider Demographics
NPI:1902016629
Name:BEGGIN, KELLY KATHLEEN (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:KATHLEEN
Last Name:BEGGIN
Suffix:
Gender:F
Credentials:MA, LMFT
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6542 REGENCY LN
Mailing Address - Street 2:SUITE 208
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-7847
Mailing Address - Country:US
Mailing Address - Phone:612-387-7133
Mailing Address - Fax:952-903-9257
Practice Address - Street 1:6542 REGENCY LN
Practice Address - Street 2:SUITE 208
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-7847
Practice Address - Country:US
Practice Address - Phone:612-387-7133
Practice Address - Fax:952-903-9257
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN1122106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist