Individual
KELLY GARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1535 E 9TH ST, ROCHESTER, IN 46975-8929
(574) 835-0708
Mailing address
1390 W 6TH ST, ROCHESTER, IN 46975-7967
(574) 835-0708
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006511A
IN
Other
Enumeration date
04/28/2018
Last updated
04/28/2018
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