Individual
KELLIANN MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8102 CLEARVISTA PKWY, INDIANAPOLIS, IN 46256-1661
(317) 957-9800
Mailing address
270 PROVIDENCE BLVD, CARMEL, IN 46032-4523
(317) 460-4072
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87000498A
IN
Other
Enumeration date
09/14/2023
Last updated
09/14/2023
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