Individual
KELLY MCCORMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15908 CHAPEL PARK DR E, NOBLESVILLE, IN 46060-4849
(574) 268-4974
Mailing address
15908 CHAPEL PARK DR E, NOBLESVILLE, IN 46060-4849
(574) 268-4974
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39002485A
IN
Other
Enumeration date
11/18/2024
Last updated
11/18/2024
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