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Individual

MRS. KELLY ANN MARIE PULLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSSW, LCSW

Contact information

Practice address
1100 E MARKET ST, LOUISVILLE, KY 40206-1838
(502) 596-1217
Mailing address
2411 BRANNING RD, LOUISVILLE, KY 40222-6228
(502) 802-5205

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
5827
KY
1041C0700X
Clinical Social Worker
Primary
3745
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100303920
KY
Enumeration date
09/22/2010
Last updated
03/17/2018
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