Individual
STEPHANIE KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1405 CREHORE ST, LORAIN, OH 44052-3325
(440) 969-5837
Mailing address
1405 CREHORE ST, LORAIN, OH 44052-3325
(440) 969-5837
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401316341111
OH
Other
Enumeration date
03/11/2014
Last updated
03/11/2014
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