Individual
DIANA RENEE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3415 AYLESFORD LN, INDIANAPOLIS, IN 46228-2881
(317) 519-0737
Mailing address
3415 AYLESFORD LN, INDIANAPOLIS, IN 46228-2881
(317) 519-0737
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34007853A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34007853A
NATIONAL ASSOCIATION OF SOCIAL WORKERS
IN
Enumeration date
06/20/2017
Last updated
07/21/2022
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