Individual
KELLY COULOPOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
402 WALL ST STE 42, VALPARAISO, IN 46383-2572
(219) 510-8043
Mailing address
1336 LAKE CHARLES AVE, CHESTERTON, IN 46304-9763
(219) 816-1590
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34009747A
IN
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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