Individual
KELLY MARIE WOODWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PC-CR
Contact information
Practice address
1451 LUCAS RD, MANSFIELD, OH 44903-8682
(419) 589-5511
(419) 589-7599
Mailing address
1451 LUCAS RD, MANSFIELD, OH 44903-8682
(419) 589-5511
(419) 589-7599
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1100414-CR
OH
Other
Enumeration date
01/08/2015
Last updated
01/08/2015
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