Kley, Mary Lou

Kley, Mary Lou is an individual health care provider with primary practice located at 1201 25Th St S , Fargo ND 58103-2311. She recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as her primary health care specialty. Kley, Mary Lou can be contacted via phone (701) 451-4900.

Contact Information

Primary practice address
1201 25Th St S Fargo ND 58103-2311
Phone: (701) 451-4900
Fax: (701) 451-5057
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 2841 North Dakota
Behavioral Health & Social Service Providers / Counselor 101Y00000X 11721 Minnesota

Profile Details

NPI number 1447395629
LBN Legal business name Kley, Mary Lou
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447395629 NPPES
Minnesota Other 067H4BR BCBSMN
Minnesota Other 62-67227 BCBSMN
Minnesota Other HP59873 BCBSMN
Minnesota Other 26563 BCBSMN
Minnesota MEDICAID 19162 BCBSMN
Minnesota MEDICAID 158498700 BCBSMN
Minnesota Other 58103-A009 BCBSMN

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