LISA B KELLY

SOUTH BEND, IN
NPI1508185141
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IN  34006209A)
Additional Taxonomies1041C0700X Social Worker, Clinical
(Licence: MD  10805)
Enumeration Date2010-05-21
Last Update Date2013-04-30
Business Address
-- LISA B KELLY LCSW
107 N EDDY ST
SOUTH BEND, IN 46617-2920
Phone number: 574-246-1036
Mailing Address
-- LISA B KELLY LCSW
132 MARQUETTE AVE
SOUTH BEND, IN 46617-1109
Phone number: 410-262-7468