Provider Demographics
NPI:1649074683
Name:PARSONS, KELLEN FRITZE-HARRIS
Entity type:Individual
Prefix:
First Name:KELLEN
Middle Name:FRITZE-HARRIS
Last Name:PARSONS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 NE 191ST ST STE 98090
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-3899
Mailing Address - Country:US
Mailing Address - Phone:651-431-6628
Mailing Address - Fax:919-561-6612
Practice Address - Street 1:2080 WOODDALE DR STE 200
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2920
Practice Address - Country:US
Practice Address - Phone:651-431-6628
Practice Address - Fax:919-561-6612
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician