Individual
KETA CROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4716 ROUND LAKE RD APT H, INDIANAPOLIS, IN 46205-2386
(317) 496-4730
Mailing address
4716 ROUND LAKE RD APT H, INDIANAPOLIS, IN 46205-2386
(317) 496-4730
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/14/2017
Last updated
01/13/2021
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