Individual
KELLY A CODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
630 E MAIN ST, SUITE 200, RICHMOND, IN 47374-4353
(765) 288-1928
(765) 935-1582
Mailing address
240 N TILLOTSON AVE, MUNCIE, IN 47304-3988
(765) 288-1928
(765) 741-0335
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34005447A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100073590
—
IN
Enumeration date
12/10/2008
Last updated
07/20/2016
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