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Individual
KELLY L ROUTH
Active
Individual
KELLY L ROUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
S.1000465
OH
1041C0700X
Clinical Social Worker
Primary
S.1000467
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08258
—
OH
Enumeration date
11/04/2009
Last updated
07/15/2016
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