Individual
KELLY LOUISE GULBRANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
322 DEPOT AVE, DIXON, IL 61021-2850
(815) 288-6057
Mailing address
PO BOX 24, WOOSUNG, IL 61091-0024
(815) 677-4429
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
04/23/2020
Last updated
04/23/2020
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