Organization
KELLY NELSON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY D NELSON (DEVELOPMENTAL INTERVENTIONIST)
(502) 724-4960
Entity
Organization
Contact information
Practice address
10606 SYCAMORE GRN, LOUISVILLE, KY 40223-2945
(502) 724-4960
Mailing address
10606 SYCAMORE GRN, LOUISVILLE, KY 40223-2945
(502) 724-4960
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
199901318
KY
Other
Enumeration date
06/17/2016
Last updated
06/17/2016
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