Individual
KELCIE MARIE SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6437 RUCKER RD STE D, INDIANAPOLIS, IN 46220-4868
(317) 405-9016
(800) 654-4116
Mailing address
132 LAKESIDE DR, PITTSBORO, IN 46167-9548
(317) 363-5849
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
09/23/2018
Last updated
10/08/2022
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