Individual
KATHLEEN ANN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
517 N WALNUT ST, BLOOMINGTON, IN 47404-3845
(812) 219-6202
Mailing address
3042 DOLLSBERRY LN, NASHVILLE, IN 47448-8228
(812) 219-6206
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006805A
IN
Other
Enumeration date
09/02/2010
Last updated
04/04/2016
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