Individual
MR. MOSES KELLY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, MS, M.ED.,
Contact information
Practice address
240 N TILLOTSON AVE, MUNCIE, IN 47304
(765) 289-1928
(765) 741-0335
Mailing address
240 N TILLOTSON AVE, MUNCIE, IN 47304-3988
(765) 289-1928
(765) 741-0335
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33008718A
IN
Other
Enumeration date
06/23/2017
Last updated
07/24/2018
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