Individual
TRACI MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OCPC
Contact information
Practice address
11671 JULIE DR NW, BALTIMORE, OH 43105-9306
(614) 400-4889
Mailing address
11671 JULIE DR NW, BALTIMORE, OH 43105-9306
(614) 400-4889
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
OCPC.0991
OH
Other
Enumeration date
01/19/2018
Last updated
01/19/2018
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