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Individual

KELLYE ECHTERNACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LMHC

Contact information

Practice address
5638 PROFESSIONAL CIR, INDIANAPOLIS, IN 46241-5042
(317) 247-8900
(317) 247-8935
Mailing address
5919 W LAKE DR, APT A, INDIANAPOLIS, IN 46224-7911
(217) 653-8712

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39002618A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000623767
UBH PIN
IN
Enumeration date
03/07/2012
Last updated
03/14/2016
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