Individual
KELLY ANN PETERSOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6950 HILLSDALE CT, INDIANAPOLIS, IN 46250-2040
(317) 621-7561
(317) 621-7608
Mailing address
6626 E 75TH STREET, STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-7561
(317) 355-6096
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
34006200A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100270530
—
IN
Enumeration date
06/26/2008
Last updated
06/27/2019
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