Individual
KELLY FRANKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4218 W WESTERN AVE, SOUTH BEND, IN 46619-2622
(574) 233-1524
Mailing address
2113 WABASH ST, SOUTH BEND, IN 46613-1138
(574) 286-8078
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
88000846A
IN
Other
Enumeration date
03/19/2020
Last updated
03/19/2020
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