Individual
KELLIE KUMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2420 WILSON AVE, MADISON, IN 47250-2135
(812) 265-8226
Mailing address
234 GREENBRIAR RD, HANOVER, IN 47243-9640
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12474982
IN
Other
Enumeration date
09/11/2024
Last updated
09/11/2024
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