Provider Information for 1336165398
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Mr. KELLY BRIAN KOCHELL LCSW, LMFT
Sex: Male
NPI: 1336165398
Last Updated: 2007-07-09
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1336165398 | ||||||||||||
| Enumeration Date | 2006-07-14 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 9292 N MERIDIAN ST STE 311 INDIANAPOLIS, IN 46260-1828 United States Phone: 317-466-8833 | Fax:317-255-7854 | ||||||||||||
| Primary Practice Address | 9292 N MERIDIAN ST STE 311 INDIANAPOLIS, IN 46260-1828 United States Phone: 317-466-8833 | Fax:317-255-7854 | ||||||||||||
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