Individual
KELLY OSTROUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED, ED.S.
Contact information
Practice address
1801 SCHNEIDER ST NE, CANTON, OH 44721-3349
(330) 494-0372
Mailing address
1801 SCHNEIDER ST NE, CANTON, OH 44721-3349
(330) 494-0372
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
21198977
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21198977
—
OH
Enumeration date
02/11/2016
Last updated
02/11/2016
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