Individual
MRS. KELLY DYAN NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10606 SYCAMORE GRN, LOUISVILLE, KY 40223-2945
(502) 724-4960
Mailing address
10606 SYCAMORE GRN, LOUISVILLE, KY 40223-2945
(502) 724-4960
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/16/2008
Last updated
02/28/2012
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