Kellan Vencil

NPI #1083143655 in Andover, Minnesota

Provider Information

NPI Number: 1083143655
Entity Type: Individual
Name: Kellan Vencil
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Professional
Enumeration Date: Jun 7, 2017
Last Updated: Jul 15, 2022

Practice Location

Address: 1875 STATION PKWY NW
City: Andover
State: Minnesota
ZIP Code: 55304-3319
Phone: (763) 482-9598

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Professional — Professional	101YP2500X	Primary

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