Individual
KELLI ANN GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
115 FARABEE DR N STE B-2, LAFAYETTE, IN 47905-5913
(765) 426-8230
Mailing address
115 FARABEE DR N STE B-2, LAFAYETTE, IN 47905-5913
(765) 426-8230
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
99105360A
IN
Other
Enumeration date
08/03/2021
Last updated
08/03/2021
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