Individual
KELLY E WARNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1033 LARCHWOOD RD, MANSFIELD, OH 44907-2424
(419) 747-4122
(419) 747-4126
Mailing address
2281 PARK AVE W, ONTARIO, OH 44906-1230
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
12/29/2017
Last updated
12/29/2017
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