Individual
SHARON DONNELLY KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., L.C.P.C.
Contact information
Practice address
6910 N MAIN ST, UNIT 13C, BOX 51, GRANGER, IN 46530-9681
(574) 524-6307
(574) 222-1507
Mailing address
50771 PHEASANT COVE DR, GRANGER, IN 46530-9500
(574) 524-6307
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39002503A
IN
101YM0800X
Mental Health Counselor
6401018507
MI
101YP2500X
Professional Counselor
180-004245
IL
Other
Enumeration date
01/11/2007
Last updated
04/08/2024
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