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1093314452
DARELL EZELL
SOUTH BEND, IN
NPI
1093314452
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2020-10-18
Last Update Date
2020-10-18
Business Address
DARELL EZELL
415 E MADISON ST
SOUTH BEND, IN 46617-2322
Phone number: 574-533-1234
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Mailing Address
DARELL EZELL
PO BOX 809
GOSHEN, IN 46527-0809
Phone number: 574-533-1234
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