| Doctor Name: | KELLY JO SENTY |
| NPI Number: | 1467878728 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LPC |
| License Number: | 00785 |
| Business Practice Address: | 1910 W Highway 61 Box 283 Grand Marais, MN - 556047508 |
| Business Phone Number: | 2183708773 |
| Business Fax Number: | 2183872248 |
| Mailing Address: | 1910 W Highway 61, GRAND MARAIS |
| State: | MN |
| Postal Code: | 556047508 |
| Phone Number: | 2183708773 |
| Fax Number: | 2183872248 |
| NPI Enumeration Date: | 03/11/2014 |
| NPI Last Update Date: | 06/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 00785 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |