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Individual

JESSICA KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7424 SHADELAND STATION WAY, INDIANAPOLIS, IN 46256-3925
(317) 288-7606
Mailing address
2859 SUTHERLAND AVE, INDIANAPOLIS, IN 46205-4072

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
33006339A
IN

Other

Enumeration date
05/30/2014
Last updated
05/30/2014
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