Individual
KELLEN FOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1117 N JACKSON ST, BLOOMINGTON, IN 47404-3385
(616) 893-0576
Mailing address
1117 N JACKSON ST, BLOOMINGTON, IN 47404-3385
(616) 893-0576
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/25/2015
Last updated
06/25/2015
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