Individual
MS. KELLY CZACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
624 E MAIN ST, LANCASTER, OH 43130-3903
(740) 678-0042
Mailing address
4 ANGELA DR, ATHENS, OH 45701-3655
(740) 856-7727
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/02/2019
Last updated
12/02/2019
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