Individual
TRACY KEDING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1451 LUCAS RD, MANSFIELD, OH 44903-8682
(419) 589-5511
Mailing address
1451 LUCAS RD, MANSFIELD, OH 44903-8682
(419) 589-5511
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
320800000X
OH
Other
Enumeration date
01/20/2017
Last updated
01/20/2017
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