Individual
HOLDEN MARK CRESWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1639 E MAIN ST LOT 7, KENT, OH 44240-2851
(330) 524-3990
Mailing address
1639 E MAIN ST, KENT, OH 44240-2855
(330) 524-3990
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
05/04/2023
Last updated
05/04/2023
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