NPI 1457819138
Kelly Shores, MALMFTLAC
Practice location
- Address
- 415 W Broadway St, Fortville, IN 46040-1462
- Phone
- (317) 710-7772
Registered specialties
Marriage & Family Therapist
Primary
Registry record
- NPI
- 1457819138
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 12 Mar 2019
- Record last updated
- 12 Mar 2019
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.