Individual
KESHIA SOUTHERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1552 TRACY RD., WHITELAND, IN 46184
(317) 560-8448
Mailing address
153 W 700 N, WHITELAND, IN 46184-9548
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
10259770
IN
Other
Enumeration date
02/01/2022
Last updated
02/01/2022
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