Individual
E'LISA KAY KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMCH, ATR, MA
Contact information
Practice address
1244 N ILLINOIS ST APT 116, INDIANAPOLIS, IN 46202-2333
(765) 480-1201
Mailing address
1244 N ILLINOIS ST APT 116, INDIANAPOLIS, IN 46202-2333
(765) 480-1201
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39003846A
IN
Other
Enumeration date
04/07/2023
Last updated
04/07/2023
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