Individual
KELLY ELIZABETH ROUDABUSH-PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
856 W COOK RD, MANSFIELD, OH 44907-5012
(419) 525-6400
Mailing address
856 W COOK RD, MANSFIELD, OH 44907-5012
(614) 563-7975
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
20790757
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2887587
—
OH
Enumeration date
05/31/2017
Last updated
05/31/2017
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